Early Versus Late Discontinuation of Empirical Antibiotics in Pediatric Oncology Patients With Fever and Neutropenia.
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The optimal timing for discontinuing antibiotics in pediatric oncology patients with unexplained fever and neutropenia remains uncertain. We analyzed 367 episodes of fever and neutropenia in hospitalized patients 0 to 19 years of age (2015 to 2022). Patients were grouped, based on antibiotic discontinuation timing: early (afebrile ≥24 h and negative cultures ≥48 h), late (ANC ≥500 cells/mm³), and intermediate (ANC <500 but afebrile ≥24 h). Among 298 culture-negative episodes, early (24.2%), late (36.2%), and intermediate (39.6%) groups showed no differences in new infections, intensive care admissions, or mortality. Outcomes were comparable for high- and low-risk patients. Early discontinuation appears safe and effective, even in high-risk patients.