发热性中性粒细胞减少症是儿童癌症患者或接受造血干细胞移植的常见并发症。反复发生的发热性中性粒细胞减少症会导致广谱抗生素的累积暴露，可能引发一系列严重的不良反应。即使在高危发热性中性粒细胞减少症患者中，短程抗生素也可能提供一个解决方案。本综述论文探讨了抗生素的已知广泛影响，强调了对癌症、抗生素和肠道微生物组之间关系的了解进展，并讨论了有关长期不良抗生素影响的新证据。作者们考虑了现有证据来指导儿科发热性中性粒细胞减少症的经验性抗生素疗程，以及未来研究的方向。 广谱抗生素与抗微生物药物耐药性、克雷伯氏菌感染、侵袭性念珠菌感染、肠道微生物失衡和可能严重影响癌症患儿或接受异基因造血干细胞移植的结局相关。短程经验性抗生素在大多数发热性中性粒细胞减少症患儿中可能安全，并提供了减少抗生素暴露风险的宝贵机会。

Febrile neutropenia is a common complication experienced by children with cancer or those undergoing hematopoietic stem cell transplantation. Repeated episodes of febrile neutropenia result in cumulative exposure to broad-spectrum antibiotics with potential for a range of serious adverse effects. Short-course antibiotics, even in patients with high-risk febrile neutropenia, may offer a solution.This review addresses the known broad effects of antibiotics, highlights developments in understanding the relationship between cancer, antibiotics, and the gut microbiome, and discusses emerging evidence regarding long-term adverse antibiotic effects. The authors consider available evidence to guide the duration of empiric antibiotics in pediatric febrile neutropenia and directions for future research.Broad-spectrum antibiotics are associated with antimicrobial resistance, Clostridioides difficile infection, invasive candidiasis, significant disturbance of the gut microbiome and may seriously impact outcomes in children with cancer or undergoing allogenic hematopoietic stem cell transplant. Short-course empiric antibiotics are likely safe in most children with febrile neutropenia and present a valuable opportunity to reduce the risks of antibiotic exposure.