Acute Oncology Management Service - Infection and Fever Advice

Getting a fever or developing an infection?

Chemotherapy temporarily reduces your ability to fight infection.

Infections develop rapidly. If you think you have an infection you will need prompt treatment in hospital. You will not get better on your own. Early infections can be treated easily. Delay could be dangerous.

Some signs that you may be starting an infection:

  • temperature is 37.5ºC or above
  • feeling unwell and temperature is below 36ºC
  • shivery / hot and cold sweats
  • a burning feeling when you pass urine
  • cough, sputum
  • feeling breathless / rapid breathing
  • confusion / disorientation
  • redness or swelling (especially around lines or drains)
  • sore throat
  • diarrhoea

Remember to report any new or worsening conditions. If you are experiencing chest pain, difficulty in breathing or severe bleeding, please call 999 immediately.

If you feel unwell, do not delay, call The Christie hotline immediately on 0161 446 3658.

Urgent advice for Clinicians

The treatment is potentially myelosuppressive.

Antibiotic guidance

  • If patient is unwell and/or pyrexial with a temp of 38ºC or above, give IV antibiotic.
  • Do not wait for blood results; adhere to one hour to antibiotic target.

For all patients give:

Antibiotic as per local policy

Please note, many chemotherapy regimens contain platinum agents, if received in the last 7 days, avoid aminoglycosides and give Meropenem 1g TDS instead.

  • Piperacillin/Tazobactam (Tazocin) 4.5g TDS. Gentamicin 5mg per kilogram OD (maximum dose 500mg)
  • If penicillin allergic (non analphylaxis) or renal failure give Meropenem 1g TDS
  • If there is no improvement within 24 - 48 hours, contact the relevant oncologist or haematologist on 0161-446-3000

Guidelines for treatment of neutropenic sepsis are available here.

 

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