ArticleAnnals of hematology2020
De-escalation of empiric broad spectrum antibiotics in hematopoietic stem cell transplant recipients with febrile neutropenia.
Article in Annals of hematology, 2020. 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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The trial behind it
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, 46 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
- Short-chain fatty acid-producing microbes differentiate non-infectious and infectious neutropenic fever in leukemia.mSystems · 2026Article
- Safety of short versus extended antibiotic therapy for neutropenic fever after hematopoietic cell transplantation.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Efficacy and safety analysis of autologous hematopoietic stem cell transplantation for extraocular retinoblastoma.Frontiers in pediatrics · 2026Article
- 2024 update of the AGIHO guideline on diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients with solid tumours and hematological malignancies.The Lancet regional health. Europe · 2025Review
- Early de-escalation of empiric antibiotic therapy in neutropenic fever: a single-center, retrospective study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- 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
- Overview of infectious complications among CAR T- cell therapy recipients.Frontiers in oncology · 2024Review
- Early de-escalation of antibiotic therapy in hospitalized cellular therapy adult patients with febrile neutropenia.Clinical hematology international · 2024Article
- Placental expanded mesenchymal-like cells (PLX-R18) for poor graft function after hematopoietic cell transplantation: A phase I study.Bone marrow transplantation · 2023Article
- Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study.Scientific reports · 2023Article
- Risk Factors for Neutropenic Sepsis Related Mortality in Children Undergoing Allogenic Hematopoietic Stem Cell Transplantation.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2023Article
- Development and implementation of "handshake rounds": An antibiotic stewardship intervention for hospitalized adult patients with hematologic malignancies.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Protective Effect of Intestinal Blautia Against Neutropenic Fever in Allogeneic Transplant Recipients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 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
- 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
- C-Reactive Protein Monitoring and Clinical Presentation of Fever as Predictive Factors of Prolonged Febrile Neutropenia and Blood Culture Positivity after Autologous Hematopoietic Stem Cell Transplantation-Single-Center Real-Life Experience.Journal of clinical medicine · 2022Article
- Bring it on: Top five antimicrobial stewardship challenges in transplant infectious diseases and practical strategies to address them.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Febrile neutropenia (FN) is a common serious complication in patients undergoing hematopoietic stem cell transplantation (HSCT) requiring urgent evaluation and initiation of empiric broad spectrum antibiotics (BSA). The appropriate duration of BSA for FN in patients with negative cultures and no identifiable infection remains undefined. We retrospectively analyzed allogenic and autologous HSCT patients with FN and negative infectious work-up at our facility from 2012 to 2018. The early de-escalation group (EDG) included those who had BSA de-escalation to fluoroquinolone prophylaxis at least 24 h prior to absolute neutrophil count (ANC) recovery after the patient was fever-free for at least 48 h. Among 297 patients undergoing their first HSCT who experienced FN with negative infectious work-up, 83 patients were de-escalated early with the remaining 214 in the standard of care group (SCG) whose BSA were continued until ANC was > 500. Duration of broad-spectrum antibiotics was shorter in EDG compared to SCG (3.86 days vs. 4.62 days, p = 0.03). Rates of mortality, new infections, and clinical decompensation requiring intensive care unit transfer and/or pressor use within 30 days were all similar between the two groups (0% vs. 0.4% p = 1.00, 0% vs. 1.4% p = 0.56, 13.2% vs. 8.4% p = 0.27). This indicates that it is safe to de-escalate antibiotics prior to ANC recovery, leading to less BSA exposure.
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Registered trials
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