ArticleAnnals of clinical microbiology and antimicrobials2024
Application of the Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the empiric antibiotic treatment of febrile neutropenia in oncological paediatric patients: experience from two paediatric hospitals in Northern Italy.
Article in Annals of clinical microbiology and antimicrobials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pediatric stewardship in Italy: a necessity, not an option - a National Multi-Society Expert Consensus on Antimicrobial and Diagnostic Stewardship (SIP, SITIP, SIMRI, SIAIP, SIMEUP, SIPPS, SICUPP, SIMIT, SIMPE, SIPINF, SIT, SIAATIP, SARNEPI, AIEOP, SIM, SITI, SIF, SIFACT, SITA, SIN).Italian journal of pediatrics · 2025Pooled it
- Beyond the Cumulative Antibiogram: A Weighted-Incidence Syndromic Combination Antibiogram to Guide Empirical Therapy of Bloodstream Infections in the Emergency Department.Infectious diseases and therapy · 2026Article
- ASP-COMPLEX: redefining antimicrobial stewardship to improve outcomes in high-risk patients with severe infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- In-Hospital Mortality Predictors and a Bayesian Weighted-Incidence Antibiogram in Infective Endocarditis: A Seven-Year Cohort Study from a Mexican Tertiary University Hospital.Medical sciences (Basel, Switzerland) · 2026Article
- A Computational Approach to Evaluating Empirical Antibiotic Coverage for Gram-Negative Bloodstream Infections in Pediatric Febrile Neutropenia.Antibiotics (Basel, Switzerland) · 2026Article
- Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide empiric antibiotic treatment for ventilator-associated pneumonia in a Mexican tertiary care university hospital.BMC infectious diseases · 2025Article
- The Clinical Implications of Inappropriate Therapy in Community-Onset Urinary Tract Infections and the Development of a Bayesian Hierarchical Weighted-Incidence Syndromic Combination Antibiogram.Antibiotics (Basel, Switzerland) · 2025Article
- State of the Art of Antimicrobial and Diagnostic Stewardship in Pediatric Setting.Antibiotics (Basel, Switzerland) · 2025Review
- Assessing the Theoretical Efficacy of Combination Therapy Against Gram-Negative Infections in Neutropenic Pediatric Cancer Patients: Insights from the Statistical Analysis of Survey Data.Antibiotics (Basel, Switzerland) · 2024Article
- Impact of a two step antimicrobial stewardship program in a paediatric haematology and oncology unit.Scientific reports · 2024Article
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19 authors.
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Abstract
backgroundGuidelines about febrile neutropenia in paediatric patients are not homogeneous; the best empiric treatment of this condition should be driven by local epidemiology. The Weighted-Incidence Syndromic Combination Antibiogram (WISCA) addresses the need for disease-specific local susceptibility evidence that could guide empiric antibiotic prescriptions based on outcome estimates of treatment regimens obtained as a weighted average of pathogen susceptibilities. This study developed a WISCA model to inform empirical antibiotic regimen selection for febrile neutropenia (FN) episodes in onco-haematological paediatric patients treated at two Italian paediatric tertiary centres.
methodsWe included blood cultures from patients with a bloodstream infection and neutropenia admitted to the Paediatric Haematology-Oncology wards in Padua and Genoa Hospitals from 2016 to 2021. WISCAs were developed by estimating the coverage of 20 antibiotics as monotherapy and of 21 combined regimens with a Bayesian probability distribution.
resultsWe collected 350 blood cultures, including 196 g-negative and 154 g-positive bacteria. Considering the most used antibiotic combinations, such as piperacillin-tazobactam plus amikacin, the median coverage for the pool of bacteria collected in the study was 78%. When adding a glycopeptide, the median coverage increased to 89%, while the replacement of piperacillin-tazobactam with meropenem did not provide benefits. The developed WISCAs showed that no monotherapy offered an adequate coverage rate for the identified pathogens.
conclusionsThe application of WISCA offers the possibility of maximizing the clinical utility of microbiological surveillance data derived from large hospitals to inform the choice of the best empiric treatment while contributing to spare broad-spectrum antibiotics.
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