Evidence map›Paper›PMID 39456544›Full record

ArticleCancers2024

Procalcitonin Level Monitoring in Antibiotic De-Escalation and Stewardship Program for Patients with Cancer and Febrile Neutropenia.

Hiba Dagher, Anne-Marie Chaftari, Ray Hachem, Ying Jiang, Ann Philip, Patricia Mulanovich, Andrea Haddad, Peter Lamie, Rita Wilson Dib, Teny M John and 4 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancers, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04983901 (An Investigator Initiated, Phase II Single-Center, Randomized, Open-Label, Prospective, Study To Determine The Impact Of Serial Procalcitonin On Improving Antimicrobial Stewardship And On The Efficacy, Safety, And Tolerability Of Imipenem-Cilastatin-Relebactam Plus/Minus Vancomycin Or Linezolid Versus Standard Of Care Antipseudomonal Beta-Lactams Plus/Minus Vancomycin Or Linezolid As Empiric Therapy In Febrile Neutropenic Adults With Cancer), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT04983901 phase2completednot on this map

An Investigator Initiated, Phase II Single-Center, Randomized, Open-Label, Prospective, Study To Determine The Impact Of Serial Procalcitonin On Improving Antimicrobial Stewardship And On The Efficacy, Safety, And Tolerability Of Imipenem-Cilastatin-Relebactam Plus/Minus Vancomycin Or Linezolid Versus Standard Of Care Antipseudomonal Beta-Lactams Plus/Minus Vancomycin Or Linezolid As Empiric Therapy In Febrile Neutropenic Adults With Cancer

TypeinterventionalSponsorM.D. Anderson Cancer CenterRan2021 to 2023Enrolled100ConditionsHematopoietic and Lymphoid Cell Neoplasm, Malignant Solid NeoplasmArmsImipenem/Cilastatin/Relebactam, Cefepime, Meropenem, Piperacillin-Tazobactam, Vancomycin
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. [Risk factors for mortality in children with severe drowning: a 10-year single-center retrospective study].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Hiba DagherDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.ORCID 0000-0002-8483-6977
Anne-Marie ChaftariDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.ORCID 0000-0001-8097-8452
Ray HachemDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.ORCID 0000-0002-8940-0793
Ying JiangDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.
Ann PhilipDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.
Patricia MulanovichDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.
Andrea HaddadDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.
Peter LamieDepartment of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Rita Wilson DibDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.
Teny M JohnDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.ORCID 0000-0002-2675-1529
Natalie J M Dailey GarnesDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.
Shahnoor AliDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.
Patrick ChaftariDepartment of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.ORCID 0000-0002-5914-6712
Issam I RaadDepartment of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
Merck & Co 58749NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

objectiveSerial procalcitonin (PCT) monitoring has been adopted to supplement clinical judgement and help guide antibiotic therapy as part of antimicrobial stewardship programs. PCT levels peak 24 to 48 h after infection onset and decline with infection resolution. We explored the role of PCT as an infection biomarker for guiding antibiotic therapy in cancer patients hospitalized for febrile neutropenia.

designProspective randomized study.

methodsPatients were enrolled between October 2021 and August 2023 and received empiric intravenous broad-spectrum antibiotics (IVBSA) for at least 48 h. PCT was measured at baseline and 48-72 h after IVBSA initiation. PCT drop 48-72 h after IVBSA initiation was defined as a reduction of 30% from baseline or a PCT level < 0.25 ng/mL. De-escalation was defined as a switch from IVBSA to oral or simplified once-daily IV therapy.

resultsOf the 89 patients with available PCT levels, 53 (60%) had a PCT drop, most of whom (79%) underwent IVBSA de-escalation. Compared with patients without a PCT drop, patients with a PCT drop had a higher de-escalation rate at 72 h (71% vs. 45%;

conclusionsIn patients with cancer and febrile neutropenia, a PCT drop was associated with earlier therapy de-escalation and shorter antibiotic duration. PCT monitoring may be useful in antimicrobial stewardship initiatives in this patient population. CLINICAL TRIALS IDENTIFIER: NCT04983901.

Indexed as

biomarkercancerfebrile neutropeniafeverneutropeniaprocalcitonin

Identifiers

PMID39456544
PMCPMC11506002

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.