Introduction to the 2024 Consensus Guidelines for the Management of Neutropenic Fever in Patients with Cancer: Principles & Practice of Neutropenic Fever

Karin A Thursky^{1

2

3

4

5

6}, Nikhil Singh^{1

2

3

7}, Monica A Slavin^{1

2

3

8}, Robert Weinkove^{9

10

11}, Gabrielle M Haeusler^{1

2

3

12

13

14

15}, Joanne Hickman¹⁶, Sophie Jessop^{17

18}, Belinda Lambros^{1

2

3

19}, David Routledge^{3

20}, Joe Sasadeusz^{4

8}, Jason A Roberts^{21

22

23

24

25}, Linda R Mileshkin²⁶, Rachel Conyers^{14

27

28}, Abby P Douglas^{1

2

3

29}; Australasian Neutropenic Fever Guidelines Steering Committee

Affiliations

¹ National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
² Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
³ Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Department of Infectious Diseases, University of Melbourne, Melbourne, Victoria, Australia.
⁵ National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, Melbourne, Victoria, Australia.
⁶ Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁷ Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁸ Victorian Infectious Diseases Service, The Peter Doherty Institute for Immunity and Infection, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁹ Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand.
¹⁰ Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.
¹¹ Wellington Blood & Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand.
¹² Department of Infectious Diseases, Royal Children's Hospital, Melbourne, Victoria, Australia.
¹³ Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
¹⁴ Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
¹⁵ The Paediatric Integrated Cancer Service, Victoria State Government, Melbourne, Victoria, Australia.
¹⁶ Patient Experience and Wellbeing, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
¹⁷ Michael Rice Department of Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia.
¹⁸ Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, New South Wales, Australia.
¹⁹ Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
²⁰ Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.
²¹ University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
²² Herston Infectious Diseases Institute (HeIDI), Metro North Health, Brisbane, Queensland, Australia.
²³ Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
²⁴ Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
²⁵ UR UM 103, University of Montpellier, Division of Anesthesia Critical Care and Emergency and Pain Medicine, Nimes University Hospital, Nimes, France.
²⁶ Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
²⁷ Cancer Therapies Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
²⁸ Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.
²⁹ Department of Infectious Diseases and Immunology, Austin Health, Melbourne, Victoria, Australia.

PMID: 41521413
DOI: 10.1111/imj.70237

Review

Introduction to the 2024 Consensus Guidelines for the Management of Neutropenic Fever in Patients with Cancer: Principles & Practice of Neutropenic Fever

Karin A Thursky et al. Intern Med J. 2025 Dec.

. 2025 Dec:55 Suppl 7:9-19.

doi: 10.1111/imj.70237.

Authors

Affiliations

¹ National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
² Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
³ Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Department of Infectious Diseases, University of Melbourne, Melbourne, Victoria, Australia.
⁵ National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, Melbourne, Victoria, Australia.
⁶ Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁷ Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁸ Victorian Infectious Diseases Service, The Peter Doherty Institute for Immunity and Infection, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁹ Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand.
¹⁰ Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.
¹¹ Wellington Blood & Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand.
¹² Department of Infectious Diseases, Royal Children's Hospital, Melbourne, Victoria, Australia.
¹³ Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
¹⁴ Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
¹⁵ The Paediatric Integrated Cancer Service, Victoria State Government, Melbourne, Victoria, Australia.
¹⁶ Patient Experience and Wellbeing, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
¹⁷ Michael Rice Department of Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia.
¹⁸ Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, New South Wales, Australia.
¹⁹ Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
²⁰ Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.
²¹ University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
²² Herston Infectious Diseases Institute (HeIDI), Metro North Health, Brisbane, Queensland, Australia.
²³ Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
²⁴ Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
²⁵ UR UM 103, University of Montpellier, Division of Anesthesia Critical Care and Emergency and Pain Medicine, Nimes University Hospital, Nimes, France.
²⁶ Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
²⁷ Cancer Therapies Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
²⁸ Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.
²⁹ Department of Infectious Diseases and Immunology, Austin Health, Melbourne, Victoria, Australia.

PMID: 41521413
DOI: 10.1111/imj.70237

Abstract

This is the introductory chapter to the 2024 Australasian Consensus Guidelines for the Management of Neutropenic Fever in Patients with Cancer, an update of the Australian consensus guidelines published in 2011. These guidelines reflect the new treatment paradigms for cancer care (such as immunotherapy, bispecific antibodies, oral targeted therapies and CAR T) given the changing risks of neutropenic fever and sepsis, the emerging challenges of antimicrobial resistance and the new models of care for managing neutropenic fever. The scope of these guidelines has been broadened to include paediatrics for the first time. Further, chapters are dedicated to antimicrobial stewardship and infection prevention, and consumer engagement and education. Recognising the longstanding challenges about decision-making in the setting of recurrent or persistent neutropenic fever, a new chapter provides guidance about antimicrobial management and investigations. This current chapter introduces the rationale for these guidelines, defines key terms used, including risk assessment, provides an overview of the key principles suitable for a systems approach to the prevention and management of infections in neutropenic patients with cancer, defines the target audience and scope of each chapter, and helps readers navigate the guidelines. We also outline the approach to guideline development, review and feedback.

Keywords: anti‐infective agents; febrile neutropenia; haematology; oncology; practice guideline.

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References

1. Lingaratnam S, Slavin MA, Koczwara B, Seymour JF, Szer J, Underhill C et al. Introduction to the Australian consensus guidelines for the management of neutropenic fever in adult cancer patients, 2010/2011. Australian Consensus Guidelines 2011 Steering Committee. Intern Med J 2011; 41: 75–81.
1. Tam CS, O'Reilly M, Andresen D, Lingaratnam S, Kelly A, Burbury K et al. Use of empiric antimicrobial therapy in neutropenic fever. Australian Consensus Guidelines 2011 Steering Committee. Intern Med J 2011; 41: 90–101.
1. Worth LJ, Lingaratnam S, Taylor A, Hayward AM, Morrissey S, Cooney J et al. Use of risk stratification to guide ambulatory management of neutropenic fever. Australian Consensus Guidelines 2011 Steering Committee. Intern Med J 2011; 41: 82–89.
1. Slavin MA, Lingaratnam S, Mileshkin L, Booth DL, Cain MJ, Ritchie DS et al. Use of antibacterial prophylaxis for patients with neutropenia. Australian Consensus Guidelines 2011 Steering Committee. Intern Med J 2011; 41: 102–109.
1. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 2011; 52: e56–e93.

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Introduction to the 2024 Consensus Guidelines for the Management of Neutropenic Fever in Patients with Cancer: Principles & Practice of Neutropenic Fever

Affiliations

Introduction to the 2024 Consensus Guidelines for the Management of Neutropenic Fever in Patients with Cancer: Principles & Practice of Neutropenic Fever

Authors

Affiliations

Abstract

References

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LinkOut - more resources

Full Text Sources

Medical