Box 2.

Research Gaps in Paediatric FN^9,10

- Optimal definition of fever and neutropenia - Routine investigations for suspected FN - Incremental value of a peripheral blood culture in addition to CVC cultures of adequate volume in children with FN - Utility of new serum biomarkers in children with FN - Impact of novel biomarkers or point of care tests on antimicrobial selection and duration, including role of PCR for respiratory viruses

- Rapid administration of broad-spectrum antibiotics, including optimal TTA - Which patients with FN will benefit from antibiotic administration within 1 hr

- Recommended empirical antibiotic regimes - Optimal empirical antibiotics in low-risk FN

- Risk stratification and care pathways - Developing a validated high-risk stratification schema for paediatric FN - Implementation and impact (clinical, economic and QoL) of risk stratification pathways - Optimal type and frequency of re-evaluation for paediatric outpatients with low-risk FN

- Treatment modification - Optimal frequency of blood culture sampling in persistently febrile paediatric patients with neutropenia who are either clinically stable or unstable - Optimal investigation and treatment for viral and fungal infections in children with FN - Safety and efficacy of short course antibiotics in children with high-risk FN - Safety and efficacy of targeted therapy for documented clinical infection - Should diagnostic and therapeutic approaches differ for prolonged continuous fever vs recurrent fever during FN

Optimal duration of antibiotic therapy - Optimal treatment duration for microbiologically documented sterile site infections during FN - Guidelines on duration of treatment by risk group - Cost-effectiveness of different approaches to managing paediatric FN