ANC 200, T 38.5°C — neutropenic fever criteria met.
- ANC
- 200 cells/µL
- Temperature
- 38.5 °C
- Systolic BP
- 118 mmHg
- Hemodynamically stable
- yes
- MDR history
- none
- Indwelling catheter / line
- no
Antibiotics
- β-lactam-1 · IV · X g every Y hours
Cultures
- Blood cultures × 2 — two separate peripheral sites
- Urinalysis with culture
Ancillary
- CBC with differential — repeat in 6 hours
- Comprehensive metabolic panel
- Lactate
Nursing
- Vital signs every 1 hour × 4 hours, then every 4 hours
- Reverse isolation precautions — neutropenic patient
Pharmacy
- Verify renal dosing on empiric antibiotics
Decisions
- Trigger met: ANC 200 cells/mm³ (<500) and temperature 38.5°C (single ≥38.3°C).
- Risk stratification: high-risk inpatient IV pathway (v1 default for the simplified algorithm).
- Empiric antipseudomonal β-lactam-1 monotherapy with β-lactam-1.
Out of scope
- Local antibiogram and unit-specific resistance patterns are not in the algorithm; consider when finalizing coverage.
- Pediatric dosing is not covered by this algorithm (adults only).
- MASCC scoring and full risk-stratification beyond hemodynamic stability are not implemented in v1.
Second opinion
Simulated colleague voice; class-level antibiotic names only. No real drug names are sent to the model.
Sign writes class-level antibiotics + "Neutropenic fever" problem. Override writes nothing.