What is your institutional approach to a restrictive “neutropenic diet”?

Simple answer: never. The "neutropenic diet" has no efficacy and may actually be nutritionally AND microbially inferior to normal diet. This has been shown by multiple studies. I like the title of the review, "Things We Do For No Reason: Neutropenic Diet."

1. Ma et al., PMID 35356218.
2. Radhakrishnan et ...

Our institutional policy is to place all neutropenic patients (ANC <500) on a "neutropenic diet" which limits exposure to raw and uncooked foods. Recently, this has become far less restrictive but still is standard for all patients who are anticipated to have prolonged neutropenia (i.e. > 7 days).

Any patient with ANC<500 with anticipated prolonged neutropenia.