{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:11:59Z","timestamp":1780546319061,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Febrile neutropenia (FN) occurs in up to 80% of patients with hematologic malignancies. Evidence suggests using extended infusions (EI) of beta\u2010lactams can improve outcomes in some populations, but there is limited clinical literature comparing cefepime standard infusion (SI) versus EI for FN. The FDA\u2010approved regimen for FN was used at a large community teaching hospital for patients with FN until a hospital\u2010wide EI beta\u2010lactam protocol was introduced that allowed for EI cefepime in FN at the physicians' discretion. We sought to compare outcomes between patients with FN who received SI and EI cefepime.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with acute myeloid or lymphocytic leukemia who developed FN between April 2014 and January 2021 were included in this single\u2010center, retrospective study. The primary outcome was to compare mean time to defervescence after the initiation of cefepime SI or EI regimens. SI regimens consisted of IV cefepime 2G q8h\/0.5\u00a0h, and EI regimens as IV cefepime 1G q8h\/4\u00a0h. Secondary outcomes included 30\u2010day all\u2010cause mortality, hospital length of stay (LOS), duration of cefepime, and need to escalate therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 193 patients were included. Baseline characteristics were similar between groups. Time to defervescence was significantly shorter with EI compared with the SI group (median 48\u2009h [48\u2013100.5] vs. 70\u2009h [48\u2013113], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.005). Cefepime duration of therapy was significantly shorter in the EI compared with the SI group (median 6.0\u2009days vs. 8.0\u2009days, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002). There was no difference between other secondary outcomes including LOS, mortality, and antibiotic escalation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite reduced total daily dose of cefepime, EI cefepime administered as a 1G\/0.5\u00a0h LD followed 2\u2009h later by 1G q8h\/4\u00a0h for FN acutely achieves more rapid defervescence than the FDA\u2010approved SI regimen and ultimately attains comparable patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2728","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T03:38:56Z","timestamp":1663213136000},"page":"798-805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Time to defervescence evaluation for extended\u2010 vs. <scp>standard\u2010infusion<\/scp> cefepime in patients with acute leukemia and febrile neutropenia"],"prefix":"10.1002","volume":"42","author":[{"suffix":"III","given":"Robert","family":"Crawford","sequence":"first","affiliation":[{"name":"Department of Pharmacy Novant Health  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3650-3959","authenticated-orcid":false,"suffix":"III","given":"Nicholson B.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Henry Ford Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana A.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Department of Radiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2109-6123","authenticated-orcid":false,"given":"Athena L. V.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Clinical Manager\u2010 Infectious Diseases Cardinal Health Innovative Delivery Solutions  Dublin Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir073"},{"key":"e_1_2_8_3_1","unstructured":"National Comprehensive Cancer Network.Prevention and treatment of cancer\u2010related infections (Version 2.2020).http:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/infections.pdf. 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