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Life sciences · Review
Cureus · November 6, 2026
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Review.
No findings were extractable from the material analysed.
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
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Febrile neutropenia (FN) is an oncological emergency that should be timely assessed and for which appropriate empirical antibacterial therapy should be initiated.The purpose of this systematic review was to critically assess the correlation between time to antibiotic administration (TTA), all-cause mortality, and specific non-fatal outcomes in children and adults with cancer.Twenty-five primary studies published between 2011 and 2026, including observational cohorts and multicomponent quality improvement interventions, were critically appraised, though the number of unique patients could not be safely added together due to some studies reporting repeated FN episodes.There was a wide range of variations in the timing of the origins, severity of the patient population, appropriateness of treatment, and the definition of endpoints.Hazard ratios (HRs) of individual studies showed discordant associations, with an adult cohort showing a higher HR per additional hour of delay (HR: 1.18, 95% CI: 1.10-1.26)and recent (adjusted) paediatric studies failing to demonstrate a consistent adverse association of delays just beyond the 60minute threshold with composite outcomes.Previously published pooled estimates from Koenig et al. were considered in interpreting the available evidence; these estimates were not independently recalculated in the present review.Other peer-reviewed studies yielded different results for stable children and those with neutropenic sepsis.Interpretation of the available evidence is constrained by clinical and methodological heterogeneity, residual confounding, variability in outcome definitions, and incomplete documentation of certain review procedures.However, prompt, appropriate antibiotics are still crucial, especially for serious illness, and the data do not support the use of TTA as a causal measure of quality of care.