PURPOSE OF REVIEW: Our aim is to review recent literature on antibiotic use in patients with neutropenia. RECENT FINDINGS: Prophylactic antibiotics are associated with risks and have limited mortality benefit. While early antibiotic use in febrile neutropenia (FN) is critical, early de-escalation or discontinuation may be safe in many patients. SUMMARY: With an increasing understanding of potential risks and benefits of use and improved risk assessment, paradigms of antibiotic use in neutropenic patients are changing.