Q03. In the US, patients with fever (≥38.3°C or 38.0°C) and absolute neutrophil count (ANC) (<500 cells/mm3) are treated with antibiotics while Japanese health insurance covers antibiotic therapy for patients with fever (>37.8°C) and ANC (<1,000 cells/mm3). Could you comment on the degree of fever required?
Summary: In the US, fever associated with febrile neutropenia is defined as an oral temperature of ≥38.3˚C or 38.0˚C if sustained over a 1-hour period. Regardless of the value used, it is important that physicians remember that fever may not be readily apparent in some patients (older patients, debilitated patients taking fever reducing agents), therefore it is important to look at individual patients to assess the significance of any temperature rise.