PT - JOURNAL ARTICLE AU - Thomas John Jackson AU - Rachel Napper AU - Gabrielle M Haeusler AU - Barry Pizer AU - Jessica Bate AU - Richard G Grundy AU - Sujith Samarasinghe AU - Paola Angelini AU - Ashley Ball-Gamble AU - Bob Phillips AU - Jessica Elizabeth Morgan TI - Can I go home now? The safety and efficacy of a new UK paediatric febrile neutropenia protocol for risk-stratified early discharge on oral antibiotics AID - 10.1136/archdischild-2021-323254 DP - 2023 Mar 01 TA - Archives of Disease in Childhood PG - 192--197 VI - 108 IP - 3 4099 - http://adc.bmj.com/content/108/3/192.short 4100 - http://adc.bmj.com/content/108/3/192.full SO - Arch Dis Child2023 Mar 01; 108 AB - Objective To evaluate a new protocol of risk stratification and early discharge for children with febrile neutropenia (FN).Design Prospective service evaluation from 17 April 2020 to 16 April 2021.Setting 13 specialist centres in the UK.Patients 405 children presenting with FN.Intervention All children received intravenous antibiotics at presentation. Risk stratification was determined using the Australian-UK-Swiss (AUS) rule and eligibility for homecare assessed using criteria including disease, chemotherapy, presenting features and social factors. Those eligible for homecare could be discharged on oral antibiotics after a period of observation proportional to their risk group.Main outcome measures Median duration of admission and of intravenous antibiotics, and percentage of patients with positive blood cultures, significant infection, readmission within 7 days of initial presentation, intensive care unit (ICU) admission, death from infection and death from other causes.Results 13 centres contributed 729 initial presentations of 405 patients. AUS rule scores were positively correlated with positive blood cultures, significant infection, ICU admission and death. 20% of children were eligible for homecare with oral antibiotics, of which 55% were low risk (AUS 0–1). 46% low-risk homecare eligible patients were discharged by 24 hours vs 2% homecare ineligible. Homecare readmission rates were 14% overall and 16% for low-risk cases (similar to a meta-analysis of previous studies). No child eligible for homecare was admitted to ICU or died.Conclusions Use of the AUS rule and homecare criteria allow for safe early outpatient management of children with FN.Data are available on reasonable request. Requests to access pseudoanonymised data shall be addressed to TJJ.