OBJECTIVE: The objective of this paper is to describe and compare the empirical antibiotic therapy used in pediatric patients with onco-hematological pathology that presented febrile neutropenia (FN) during a period of 5 years at a referential institution in Bucaramanga, Colombia. METHODOLOGY: Descriptive study of retrospective cohort type performed between the years 2013 and 2017, in patients with FN between 1 month of age and 18 years old, hospitalized at Materno Infantil San Luis Clinic (CMISL, for its Spanish acronym) (Bucaramanga, Colombia) with onco-hematological pathology. The data were collected with REDCap® tool and the bivariate analysis was performed in Stata 14.0. RESULTS: The study included 130 patients for 315 FN total episodes, from which 64.13% of the cases were initially treated with monotherapy, being Piperacillin Tazobactam (PTZ) (n=91, 45.05%) and Cefepime (FEP) (n=84, 41.58%) the most used. The episodes treated with PTZ and FEP were compared. Patients exposed to PTZ presented more signs of gastrointestinal focus (n=48 [31.17%] vs n=22 [18.49%], p. 0.02), higher bacterial isolates (n=55 [35.71%] vs n=33 [27.73%], p. 0.03), had predominance of Gram-negative bacilli (GNB) isolation (n=49 [31.82%] vs n=22 [18.49%], p. 0.01) and required higher use of granulocyte-colony stimulants (n=48 [31.17%] vs n=22 [18.49%], p. 0.02). CONCLUSIONS: No significant differences in the outcomes were identified between the empirical therapy with PTZ and FEP; no evidence was found to conclude that one of these treatments is superior to the other in terms of safety or effectiveness. [ABSTRACT FROM AUTHOR]