Timing of initial antibiotic treatment for febrile neutropenia in the emergency department: The need for evidence-based guidelines

Guidelines for the treatment of febrile neutropenia (FN) universally recommend the prompt initiation (<60 minutes) of antibiotic therapy for patients with this complication presenting to medical settings. Unfortunately, administration delays exist in emergency departments where patients with FN frequently seek care. Future guidelines should be based on investigations that clearly indicate the effectiveness of rapid antibiotic therapy. If definitive investigations identify an optimal time period for the initial administration of antibiotics for patients with FN administrative efforts will be developed to improve the emergency department care of these critically ill patients with cancer.