ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2018
De-escalation and discontinuation strategies in high-risk neutropenic patients: an interrupted time series analyses of antimicrobial consumption and impact on outcome.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Early discontinuation vs. continuation of empirical antibiotics in patients with cancer and febrile neutropenia: a systematic review and meta-analysis of randomized controlled trials.Frontiers in microbiology · 2026Pooled it
- Impact of an antimicrobial stewardship intervention on carbapenem use in children with cancer.Infection · 2026Article
- Early de-escalation of empiric antibiotic therapy in neutropenic fever: a single-center, retrospective study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- The long-term impact of an antimicrobial stewardship program in febrile neutropenia: an 8 years follow up.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Variation in Antibiotic Prescription in High-Risk Febrile Neutropenia in Portuguese Hospitals.Antibiotics (Basel, Switzerland) · 2024Article
- Antimicrobial De-Escalation in Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Efficacy of an antimicrobial stewardship intervention for early adaptation of antibiotic therapy in high-risk neutropenic patients.Antimicrobial resistance and infection control · 2024Article
- Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms.Microorganisms · 2023Review
- Review
- Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis.Antibiotics (Basel, Switzerland) · 2023Article
- Antimicrobial stewardship in high-risk febrile neutropenia patients.Antimicrobial resistance and infection control · 2022Observational
- 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
- 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
- Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute.GMS hygiene and infection control · 2022Article
- 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
- Impact of the multidisciplinary antimicrobial stewardship team intervention focusing on carbapenem de-escalation: A single-centre and interrupted time series analysis.International journal of clinical practice · 2021Article
- Article
- 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
- Real-world management of infection during chemotherapy for acute leukemia in Japan: from the results of a nationwide questionnaire-based survey by the Japan Adult Leukemia Study Group.International journal of hematology · 2020Article
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Febrile neutropenia (FN) is the main reason for antibiotic prescription in hematology wards where, on the other hand, antibiotic stewardship (AS) is poorly explored. The objectives of the present study were to evaluate (1) the impact of an AS intervention on antibiotic consumption and (2) the applicability and acceptance rate of the intervention and its clinical impact. A persuasive AS intervention based on European Conference on Infection in Leukaemia (ECIL) guidelines for FN was implemented in a high-risk hematology ward in a tertiary referral public university hospital. This included the creation and diffusion of flow charts on de-escalation and discontinuation of antibiotics for FN, and the introduction in the team of a doctor dedicated to the implementation of flow charts and to antibiotic prescription revision. All consecutive patients receiving antibiotics during hospitalization were included. A segmented linear regression model was performed for the evaluation of antibiotic consumption, taking into account 1-year pre-intervention period and 6-month intervention period. Overall, 137 consecutive antibiotic prescriptions were re-evaluated, 100 prescriptions were for FN. A significant reduction of the level of carbapenem consumption was observed during the intervention period (level change (estimate coefficient ± standard error) = - 135.28 ± 59.49; p = 0.04). Applicability and acceptability of flow charts were high. No differences in terms of intensive care unit transfers, bacteremia incidence, and mortality were found. A persuasive AS intervention in hematology significantly reduced carbapenem consumption without affecting outcome and was well accepted. This should encourage further applications of ECIL guidelines for FN.
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