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haematology oncology infectious-disease

CISNE Score for Febrile Neutropenia

Clinical Index of Stable Febrile Neutropenia (CISNE). Stratifies risk in clinically stable febrile neutropenic cancer patients receiving outpatient/oral therapy. Predicts serious complications.

Score interpretation

CISNE 0 — Low Risk (<1% Complications)

→ CISNE 0: Very low complication risk (<1%). Outpatient oral antibiotic therapy appropriate for selected, clinically stable patients: oral ciprofloxacin + co-amoxiclav; strict return criteria; review in 24 hours. Only if adequately supervised.

CISNE 1–2 — Intermediate Risk (~6%)

→ CISNE 1–2: ~6% risk of serious complications. Hospital admission recommended; IV antibiotics (piperacillin-tazobactam or meropenem if high-risk pathogen); daily review; microbiological investigations.

CISNE ≥3 — High Risk (>36%)

→ CISNE ≥3: >36% risk of serious complications. Inpatient IV antibiotic therapy mandatory; broad-spectrum cover (piperacillin-tazobactam ± aminoglycoside); consider GCSF; haematology review; antifungal if fever persists >96 hours.

Interpretation bands for the CISNE Score. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.