CISNE Score for Febrile Neutropenia
Clinical Index of Stable Febrile Neutropenia (CISNE). Predicts serious complications in adults with solid tumours and seemingly stable febrile neutropenia (no organ dysfunction, abnormal vital signs or major infection). Validated in solid tumours only.
Score interpretation
→ 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: ~6% risk of serious complications. Hospital admission recommended; IV antibiotics (piperacillin-tazobactam or meropenem if high-risk pathogen); daily review; microbiological investigations.
→ CISNE ≥3: ~32–36% 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.
- Fong Clinical Risk Score for Colorectal Cancer Recurrence · Oncology
- CRASH Score for Chemotherapy Risk Assessment in Elderly Patients · Oncology
- Ann Arbor Staging System for Lymphoma · Oncology
- Rai Staging System for CLL · Oncology
- Follicular Lymphoma International Prognostic Index (FLIPI) · Oncology
- International Staging System for Multiple Myeloma (ISS) · Oncology
- Meropenem (Paediatric) · Carbapenem — Severe / MDR Gram-Negative Infections / Febrile Neutropenia
- Isosorbide Mononitrate (Stable Angina) · Nitrate / Stable Angina
- Nicorandil · Stable Angina
- Ranolazine · Refractory Stable Angina
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Zoledronic Acid · Bisphosphonate (IV)
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.