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Arch Dis Child Educ Pract Ed 98:73-75 doi:10.1136/archdischild-2013-303634
  • Guideline review

Neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients (NICE Clinical Guideline CG151)

Editor's Choice
  1. Julia Chisholm7
  1. 1Division of Clinical Sciences, Paediatric Infectious Diseases Research Group, St. George's, University of London, London, UK
  2. 2Department of Paediatric Oncology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
  3. 3London South Bank University, London, UK
  4. 4Oncology Unit, Royal Hospital for Sick Children, Edinburgh, UK
  5. 5Oncology Unit, Alder Hey Childrens NHS Foundation Trust, Liverpool, UK
  6. 6Department of Paediatric and Adolescent Oncology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  7. 7Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Sutton, UK
  1. Correspondence to Dr Jessica Bate, Division of Clinical Sciences, Paediatric Infectious Diseases Research Group, St. George's, University of London, London SW17 0RE, UK; jbate{at}sgul.ac.uk
  • Received 8 January 2013
  • Revised 6 February 2013
  • Accepted 8 February 2013

Information about current guideline

In September 2012, the National Institute for Clinical Excellence (NICE) published a guideline entitled ‘Neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients’.1 The aim of the guideline is to ‘improve outcomes by providing evidence-based recommendations on the prevention, identification and management of this life-threatening complication of cancer treatment’ for children, young people and adults. The National Collaborating Centre for Cancer was commissioned by NICE to develop the guideline and establish a Guideline Development Group, including children and young people's cancer nurses and consultants, which reviewed the evidence and developed the recommendations.

Previous guideline

There are no previously published national guidelines for the management of neutropenic sepsis in children. In July 2008, the Children's Cancer and Leukaemia Group (CCLG) produced a framework document for the treatment of febrile neutropenia, focusing on the definitions of fever and neutropenia, and on developing a practical management strategy for low-risk patients, which individual centres could incorporate into local policies. The document was produced in response to a survey suggesting wide variation in the definitions and management of febrile neutropenia, following an exhaustive literature review, small group discussion and a national Delphi consensus process.2 ,3 A recent audit of UK paediatric oncology centres revealed that current practice differs widely from recommendations contained within the CCLG framework.4

Box 2

Resources

  • http://guidance.nice.org.uk/CG151 Link to NICE guideline and full guideline

  • http://guidance.nice.org.uk/CG151/PublicInfo/pdf/ English Link to public information on neutropenic sepsis guidance

  • http://www.nice.org.uk/newsroom/podcasts/index.jsp?pid=45 Neutropenic sepsis: prophylaxis podcast with Dr Bob Phillips

Controversial and key issues that the guideline addresses

  • Definition of febrile neutropenia: Neutrophils 0.5×109/l or lower …