{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:36:14Z","timestamp":1769560574614,"version":"3.49.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Antimicrobial Use and Resistance in Australia"},{"DOI":"10.13039\/501100003921","name":"Australian Government Department of Health and Aged Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008999","name":"Australian Commission on Safety and Quality in Health Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008999","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Neutropenic fever (NF) is a common complication in patients receiving chemotherapy. Judicious antimicrobial use is paramount to minimize morbidity and mortality and to avoid antimicrobial-related harms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To use an Australian national dataset of antimicrobial prescriptions for the treatment of NF to describe antimicrobial use, prescription guideline compliance and appropriateness; and to compare these findings across different healthcare settings and patient demographics. We also aimed to identify trends and practice changes over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were extracted from the Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) database from August 2013 to May 2022. Antimicrobial prescriptions with a NF indication were analysed for antimicrobial use, guideline compliance and appropriateness according to the Hospital NAPS methodology. Demographic factors, hospital classifications and disease characteristics were compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 2887 (n = 2441 adults, n = 441 paediatric) NF prescriptions from 254 health facilities were included. Piperacillin-tazobactam was the most prescribed antimicrobial. Overall, 87.4% of prescriptions were appropriate. Piperacillin-tazobactam and cefepime had the highest appropriateness though incorrect piperacillin-tazobactam dosing was observed. Lower appropriateness was identified for meropenem, vancomycin, and gentamicin prescribing particularly in the private hospital and paediatric cohorts. The most common reasons for inappropriate prescribing were spectrum too broad, incorrect dosing or frequency, and incorrect duration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study provides insights into antimicrobial prescribing practices for NF in Australia. We have identified three key areas for improvement: piperacillin-tazobactam dosing, paediatric NF prescribing and private hospital NF prescribing. Findings from this study will inform the updated Australian and New Zealand consensus guidelines for the management of neutropenic fever in patients with cancer.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae015","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T14:33:44Z","timestamp":1706884424000},"page":"632-640","source":"Crossref","is-referenced-by-count":7,"title":["Antimicrobial use and appropriateness in neutropenic fever: a study of the Hospital National Antimicrobial Prescribing Survey data"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5264-2447","authenticated-orcid":false,"given":"Nikhil","family":"Singh","sequence":"first","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne , Australia"},{"name":"Pharmacy Department, Peter MacCallum Cancer Centre , Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8314-352X","authenticated-orcid":false,"given":"Abby P","family":"Douglas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne , Australia"},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne , Australia"},{"name":"Department of Infectious Diseases, Austin Health , Melbourne , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-314X","authenticated-orcid":false,"given":"Monica A","family":"Slavin","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne , Australia"},{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne , Australia"},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne , Australia"},{"name":"Victorian Infectious Diseases Service, Royal Melbourne Hospital , Melbourne , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle M","family":"Haeusler","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne , Australia"},{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin A","family":"Thursky","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, Peter MacCallum Cancer Centre , Melbourne , Australia"},{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne , Australia"},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne , Australia"},{"name":"National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, University of Melbourne , Melbourne , Australia"},{"name":"RMH Guidance Group, Royal Melbourne Hospital , Melbourne , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"2024030105174775000_dkae015-B1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1200\/JOP.18.00269","article-title":"Optimal management of neutropenic fever in patients with cancer","volume":"15","author":"Zimmer","year":"2019","journal-title":"J Oncol Pract"},{"key":"2024030105174775000_dkae015-B2","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1097\/QCO.0000000000000872","article-title":"New approaches to management of fever and neutropenia in high-risk patients","volume":"35","author":"Douglas","year":"2022","journal-title":"Curr Opin Infect Dis"},{"key":"2024030105174775000_dkae015-B3","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/j.1445-5994.2010.02339.x","article-title":"Use of risk stratification to guide ambulatory management of neutropenic fever. 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