ArticleOpen forum infectious diseases2022
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.
Article in Open forum infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Optimizing methods to detect colonization with fluoroquinolone-resistant viridans group streptococci prior to hematopoietic cell transplantation.Journal of clinical microbiology · 2026Article
- Colonization with extended-spectrum and AmpC β-lactamase-producing Enterobacterales and bacteremia risk in patients with acute leukemia who receive induction chemotherapy without fluoroquinolone prophylaxis.Antimicrobial agents and chemotherapy · 2026Article
- Frontline Febrile Neutropenia Antibiotic Treatment Across Institution Types: A Multicenter Survey Study.Open forum infectious diseases · 2026Article
- The impact of fluoroquinolone-resistant enterobacterales colonization on fluoroquinolone prophylaxis efficacy in hematopoietic cell transplant recipients.BMC infectious diseases · 2025Article
- Article
- Pre-engraftment bacteremia after allogeneic hematopoietic cell transplantation without primary fluoroquinolone antibacterial prophylaxis.Transplant infectious disease : an official journal of the Transplantation Society · 2024Observational
- Healthcare professional perspectives following implementation of an infection management care pathway for pediatric patients with cancer: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Bring it on again: antimicrobial stewardship in transplant infectious diseases: updates and new challenges.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- Global impact of antibacterial resistance in patients with hematologic malignancies and hematopoietic cell transplant recipients.Transplant infectious disease : an official journal of the Transplantation Society · 2023Review
- Best Practices in the Management of Infectious Complications for Patients With Cancer: Management of Febrile Neutropenia.Journal of the advanced practitioner in oncology · 2023Article
- Challenges and Opportunities in Antimicrobial Stewardship among Hematopoietic Stem Cell Transplant and Oncology Patients.Antibiotics (Basel, Switzerland) · 2023Article
- Review
- Bring it on: Top five antimicrobial stewardship challenges in transplant infectious diseases and practical strategies to address them.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Review
- Approach to fever in patients with neutropenia: a review of diagnosis and management.Therapeutic advances in infectious diseaseReview
Corrections and comments
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Authors and funding
7 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundContemporary information regarding fever and neutropenia (FN) management, including approaches to antibacterial prophylaxis, empiric therapy, and de-escalation across US cancer centers, is lacking.
methodsThis was a self-administered, electronic, cross-sectional survey of antimicrobial stewardship physicians and pharmacists at US cancer centers. The survey ascertained institutional practices and individual attitudes on FN management in high-risk cancer patients. A 5-point Likert scale assessed individual attitudes.
resultsProviders from 31 of 86 hospitals (36%) responded, and FN management guidelines existed in most (29/31, 94%) hospitals. Antibacterial prophylaxis was recommended in 27/31 (87%) hospitals, with levofloxacin as the preferred agent (23/27, 85%). Cefepime was the most recommended agent for empiric FN treatment (26/29, 90%). Most institutional guidelines (26/29, 90%) recommended against routine addition of empiric gram-positive agents except for specific scenarios. Eighteen of 29 (62%) hospitals explicitly provided guidance on de-escalation of empiric, systemic antibacterial therapy; however, timing of de-escalation was variable according to clinical scenario. Among 34 individual respondents, a majority agreed with use of antibiotic prophylaxis in high-risk patients (25, 74%). Interestingly, only 10 (29%) respondents indicated agreement with the statement that benefits of antibiotic prophylaxis outweigh potential harms.
conclusionMost US cancer centers surveyed had institutional FN management guidelines. Antibiotic de-escalation guidance was lacking in nearly 40% of centers, with heterogeneity in approaches when recommendations existed. Further research is needed to inform FN guidelines on antibacterial prophylaxis and therapy de-escalation.
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Registered trials
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