{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:26:18Z","timestamp":1788452778498,"version":"build-2803163510"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck & Co","doi-asserted-by":"crossref","award":["58749"],"award-info":[{"award-number":["58749"]}],"id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The University of Texas MD Anderson Cancer Center Support","award":["P30CA016672"],"award-info":[{"award-number":["P30CA016672"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antibiotic overuse leads to the emergence of antibiotic resistance that threatens immunocompromised cancer patients. Infections caused by MDR Gram-negative pathogens are difficult to treat and associated with high mortality. Hence, empirical therapy with standard-of-care (SOC) antibiotics could be suboptimal in these vulnerable patients. New antibiotics covering potential resistant pathogens may be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a randomized non-inferiority study comparing safety and efficacy of imipenem\/cilastatin\/relebactam (IPM\/REL), a \u03b2-lactam\/\u03b2-lactamase inhibitor combination, with SOC antibiotics (cefepime, piperacillin\/tazobactam or meropenem) in cancer patients with febrile neutropenia. Patients received at least 48 h of IV antibiotics and were assessed at end-of-IV (EOIV) therapy, test of cure (TOC; Days 21\u201328), and late follow-up (LFU; Days 35\u201342).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 100 patients were enrolled (49 IPM\/REL and 50 SOC). Demographics and rates of documented microbiological infections were similar in both groups. In the SOC arm, 86% of antibiotics consisted of cefepime. Patients on IPM\/REL had a higher favourable clinical response at EOIV than those on SOC (90% versus 74%; P\u200a=\u200a0.042); however, responses were similar at TOC and LFU. Microbiological eradication was comparable at all three timepoints. Study drug-related adverse events and adverse events leading to drug discontinuation were similar in both groups, with no study drug-related mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest that compared with SOC antibiotics, predominantly cefepime, IPM\/REL for empirical coverage of febrile neutropenia in cancer patients is generally safe and could be associated with a better clinical outcome at EOIV. The current SOC consisting mainly of agents that do not cover for ESBL-producing and carbapenem-resistant Enterobacterales bacteria should be reconsidered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkae254","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T17:22:25Z","timestamp":1720804945000},"page":"2543-2553","source":"Crossref","is-referenced-by-count":12,"title":["A randomized non-inferiority study comparing imipenem\/cilastatin\/relebactam with standard-of-care Gram-negative coverage in cancer patients with febrile neutropenia"],"prefix":"10.1093","volume":"79","author":[{"given":"Anne-Marie","family":"Chaftari","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, Unit 1460, The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Houston, TX 77030 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