Observational studyAntimicrobial resistance and infection control2022
Antimicrobial stewardship in high-risk febrile neutropenia patients.
Observational study in Antimicrobial resistance and infection control, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 46 citations in OpenAlex.
- Does the severity of neutropenia affect mortality in bacteremic cancer patients?BMC infectious diseases · 2026Article
- Article
- Sustaining stewardship: longitudinal evaluation of an integrated antimicrobial programme in the ICU.The Journal of antimicrobial chemotherapy · 2026Article
- Provider perceptions of an antimicrobial stewardship program in immunocompromised patients at a cancer center.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- An enhanced nutrition support system is associated with greater adequacy of enteral nutrition in long-term ICU patients: a retrospective cohort study.BMC nutrition · 2025Article
- Article
- Antimicrobial stewardship reduces antibiotic use density and cost in a Chinese tertiary hospital.Scientific reports · 2025Article
- 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
- Adopting prospective antimicrobial stewardship (AMS) practice in high-risk immunosuppressed groups: an urgent call to action in the era of antimicrobial resistance (AMR).JAC-antimicrobial resistance · 2024Review
- An Institutional Febrile Neutropenia Protocol Improved the Antibacterial Treatment and Encouraged the Development of a Computerized Clinical Decision Support System.Antibiotics (Basel, Switzerland) · 2024Article
- Impact of an antimicrobial stewardship programme on antibiotic utilization and resistance burden in patients with acute leukaemia: an 11-year longitudinal cohort study using interrupted time-series analysis.The Journal of antimicrobial chemotherapy · 2024Article
- Antimicrobial De-Escalation in Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Brave New World of Artificial Intelligence: Its Use in Antimicrobial Stewardship-A Systematic Review.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
- Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible.Microorganisms · 2023Article
- Antimicrobial stewardship programs in solid-organ transplant recipients in Switzerland.Transplant infectious disease : an official journal of the Transplantation Society · 2022Article
- Approach to fever in patients with neutropenia: a review of diagnosis and management.Therapeutic advances in infectious diseaseReview
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Authors and funding
16 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 2011 4th European Conference on Infections in Leukemia (ECIL4) guidelines recommend antibiotics de-escalation/discontinuation in selected febrile neutropenia (FN) patients. We aimed to assess the impact of an antimicrobial stewardship (AMS) program based on these guidelines on antibiotics use and clinical outcomes in high-risk FN patients.
methodsWe conducted an observational study in the hematology department of Cochin University Hospital in Paris, France. An ECIL4-based antibiotics de-escalation and discontinuation strategy was implemented jointly by the hematologists and the AMS team. The pre-intervention (January-October 2018) and post-intervention (January-October 2019) periods were compared. We retrospectively collected clinical and microbiological data. We compiled antibiotics consumptions via hospital pharmacy data and standardized them by calculating defined daily doses per 1000 patient-days. We analyzed the two-monthly antibiotic consumption using an interrupted time series method and built a composite endpoint for clinical outcomes based on transfer to the intensive care unit (ICU) and/or hospital death.
resultsOverall, 273 hospital stays (164 patients) in the pre-intervention and 217 (148 patients) in the post-intervention periods were analyzed. Patients were mainly hospitalized for intensive chemotherapy for acute leukemia or autologous stem-cell transplant for myeloma. Patients were slightly younger in the pre-intervention compared to the post-intervention period (median age 60.4 vs 65.2 years, p = 0.049), but otherwise comparable. After implementation of the AMS program, glycopeptide and carbapenem use decreased by 85% (p = 0.03) and 72% (p = 0.04), respectively. After adjustment on confounders, the risk of transfer to the ICU/death decreased significantly after implementation of the AMS program (post-intervention period: odds-ratio = 0.29, 95% Confidence Interval: 0.15-0.53, p < 0.001).
conclusionImplementation of a multidisciplinary AMS program for high-risk neutropenic patients was associated with lower carbapenem and glycopeptide use and improved clinical outcomes.
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