ArticleOpen forum infectious diseases2017
Early Antimicrobial De-escalation and Stewardship in Adult Hematopoietic Stem Cell Transplantation Recipients: Retrospective Review.
Article in Open forum infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Efficacy and safety of early antibiotic de-escalation in febrile neutropenia for patients with hematologic malignancy: a systematic review and meta-analysis.Antimicrobial agents and chemotherapy · 2025Pooled it
- Early Discontinuation of Empiric Antibiotics in Pediatric Haploidentical Hematopoietic Cell Transplant Recipients with Febrile Neutropenia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Antimicrobial Stewardship in Transplant Recipients: A Scoping Review of Interventions, Outcomes, and Policy Implications.Infectious diseases & clinical microbiology · 2026Article
- Safety of short versus extended antibiotic therapy for neutropenic fever after hematopoietic cell transplantation.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Article
- Clinical Characteristics and Optimization of Empirical Antimicrobial Therapy for Febrile Neutropenia in Patients With Hematologic Malignancies.Infection and drug resistance · 2025Review
- Efficacy of an antimicrobial stewardship intervention for early adaptation of antibiotic therapy in high-risk neutropenic patients.Antimicrobial resistance and infection control · 2024Article
- Early de-escalation of antibiotic therapy in hospitalized cellular therapy adult patients with febrile neutropenia.Clinical hematology international · 2024Article
- Safety and Efficacy of Antibiotic De-escalation and Discontinuation in High-Risk Hematological Patients With Febrile Neutropenia: A Single-Center Experience.Open forum infectious diseases · 2022Article
- Variation in Clinical Practice and Attitudes on Antibacterial Management of Fever and Neutropenia in Patients With Hematologic Malignancy: A Survey of Cancer Centers Across the United States.Open forum infectious diseases · 2022Article
- Successful management of colistin- and carbapenem-resistantSAGE open medical case reports · 2022Article
- Clinical Application of Metagenomic Next-Generation Sequencing in Patients with Hematologic Malignancies Suffering from Sepsis.Microorganisms · 2021Article
- Reductions in vancomycin and meropenem following the implementation of a febrile neutropenia management algorithm in hospitalized adults: An interrupted time series analysis.Infection control and hospital epidemiology · 2021Article
- Pharmacist-Driven Antibiotic Stewardship Program in Febrile Neutropenic Patients: A Single Site Prospective Study in Thailand.Antibiotics (Basel, Switzerland) · 2021Article
- Long-Term Impact of an Educational Antimicrobial Stewardship Program on Management of Patients with Hematological Diseases.Antibiotics (Basel, Switzerland) · 2021Article
- Antimicrobial de-escalation in patients with high-risk febrile neutropenia: Attitudes and practices of adult hospital care providers.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2021Article
- Updates in infection risk and management in acute leukemia.Hematology. American Society of Hematology. Education Program · 2020Review
- De-escalation of empiric broad spectrum antibiotics in hematopoietic stem cell transplant recipients with febrile neutropenia.Annals of hematology · 2020Article
- Practicing Antimicrobial Stewardship: De-Escalating Antibiotics in Patients With Acute Myeloid Leukemia and Neutropenic Fever.Open forum infectious diseases · 2020Article
- Biomarker-guided antifungal stewardship policies for patients with invasive candidiasis.Current medical mycology · 2018Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial stewardship in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients remains underutilized in North America. European guidelines advise de-escalation of broad-spectrum therapy after 72 hours in select patients with neutropenic fever of unknown origin. This is not commonplace in the United States, as current guidelines recommend broad-spectrum therapy until neutrophil engraftment. If de-escalating after at least 5 days of broad-spectrum therapy and defervescence in neutropenic allo-HSCT recipients does not predispose them to recurrent fever or infection, the practice could afford several benefits.
methodsThe primary end point was rate of recurrent fever. Secondary outcomes included
resultsA total of 120 patients were assessed in 2 groups as cohort 1 (n = 46), which received early de-escalation, and cohort 2 (n = 74), which did not. The primary end point met criteria for noninferiority, as 7 patients (15%) in cohort 1 had recurrent fever within the specified time frame compared with 14 (19%) in cohort 2 (90% CI, -0.0878 to 0.1629,
conclusionsDe-escalating after at least 5 days of broad-spectrum therapy and defervescence did not appear to affect the rate of recurrent fever. This allowed for significant reductions in gram-positive broad-spectrum antimicrobial utilization, with trends toward lower use of broad-spectrum gram-negative agents and associated costs and no difference in clinical outcomes compared with those continuing such therapy until neutrophil engraftment.
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