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International guidelines recommend antipseudomonal \u03b2-lactam monotherapy for stable patients, however, modification\u200b to carbapenems often occurs without confirmed infection.\u200b<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted\u200b a retrospective cohort study\u200b at\u200b a single tertiary pediatric oncology center to assess the impact\u200b of\u200b a carbapenem-sparing AMS intervention\u200b in children during neutropenia. All pediatric cancer patients with\u200b at least one episode\u200b of\u200b suspected infection between January 2021 and October 2024 were included.\u200b The intervention combined training, updated standard operating procedures, multidrug-resistant (MDR) surveillance swabs, and\u200b a structured protocol reassessing meropenem treatment\u200b.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 254 patients, 116 met the inclusion criteria, accounting for 432\u200b episodes (270 pre- and 162 post-intervention). Re-modification\u200b of antimicrobial therapy from meropenem\u200b to piperacillin\/tazobactam was achieved\u200b in\u200b 16\u200b of\u200b 50 post-intervention episodes. The median duration\u200b of meropenem treatment decreased from\u200b 9\u200b to\u200b 6\u00a0days\u200b (\n                      <jats:italic>p\u200b<\/jats:italic>\n                      \u2009=\u2009\n                      <jats:italic>0.006<\/jats:italic>\n                      ). Interrupted time series analysis showed\u200b a non-significant reduction\u200b in meropenem use, corresponding\u200b to\u200b an estimated decline\u200b of 40.7\u00a0days of therapy (DOT) per 1000 patient-days per quarter. Mortality was unchanged\u00a0(3.8%\u200b vs 4.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings demonstrate that a structured AMS intervention is feasible and effective\u200b in pediatric oncology, reducing unnecessary meropenem exposure without compromising safety. While this approach may serve\u200b as\u200b a model for broader multicenter efforts\u200b to promote individualized, evidence-based antimicrobial use, the low number\u200b of blood stream infections (BSI)\u200b in our cohort limits the ability\u200b to draw definitive conclusions about the clinical impact\u200b of MDR screening\u200b on infection-related outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02813-y","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T07:58:18Z","timestamp":1780300698000},"page":"1931-1943","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of an antimicrobial stewardship intervention on carbapenem use in children with cancer"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4812-9220","authenticated-orcid":false,"given":"Sarina K.","family":"Butzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3052-2147","authenticated-orcid":false,"given":"Katrin","family":"Mehler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Oberthuer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7613-8119","authenticated-orcid":false,"given":"Lena M.","family":"Biehl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Kuehne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0696-7282","authenticated-orcid":false,"given":"Pablo","family":"Landgraf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3425-8451","authenticated-orcid":false,"given":"Thorsten","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-0772","authenticated-orcid":false,"given":"Norma","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"2813_CR1","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.1200\/JCO.22.02224","volume":"41","author":"T Lehrnbecher","year":"2023","unstructured":"Lehrnbecher T, Robinson PD, Ammann RA, et al. 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NJ serves \u043en the editorial board \u043ef Die Innere Medizin (Springer Nature) and contributes t\u043e the podcast Consilium infectorum (Infectopharm). NJ \u0456s also a member \u043ef the scientific board \u043ef Streamed-up (InfektioLive). All other authors declare that they have no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This research study was conducted retrospectively from data obtained for clinical purposes. We consulted with the Ethics committee Cologne who confirmed that no ethical approval is required.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}