{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:08:33Z","timestamp":1780502913526,"version":"3.54.1"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Onco-haematological patients with febrile neutropenia are at high risk of severe infections caused by multidrug-resistant pathogens. Continuous infusion (CI) of beta-lactams may improve pharmacokinetic\/pharmacodynamic (PK\/PD) target attainment, yet evidence in this population remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the likelihood of achieving an aggressive PK\/PD target with CI beta-lactams during the first week of therapy in onco-haematological patients and to identify predictors of target non-attainment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study enrolled adult onco-haematological patients receiving CI beta-lactams for empirical or targeted treatment over a 1-year period. Steady-state plasma concentrations were measured between days 3 and 7. The aggressive PK\/PD target was defined as a free steady-state concentration-to-MIC (or clinical breakpoint) ratio \u22654; for beta-lactam\/beta-lactamase inhibitor combinations, a joint PK\/PD target was applied. Multivariate logistic regression analysis identified factors associated with target attainment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 256 patients were included, 82 of whom (32.1%) received targeted therapy. Aggressive PK\/PD target attainment was achieved in 85.4% of patients undergoing targeted treatment, compared with 57.5% of those treated empirically. Target non-attainment occurred most frequently with piperacillin\/tazobactam and ceftazidime\/avibactam. Augmented renal clearance (OR 12.29, P\u200a&amp;lt;\u200a0.001), male sex (OR 3.79, P\u200a&amp;lt;\u200a0.001) and age &amp;lt;65\u2005years (OR 2.40, P\u200a=\u200a0.025) independently predicted target non-attainment, whereas targeted therapy and meropenem use were associated with a higher attainment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CI beta-lactams reliably achieve aggressive PK\/PD targets during targeted therapy but not during empirical treatment in onco-haematological patients. Augmented renal clearance is a major determinant of underexposure, supporting the use of therapeutic drug monitoring to optimize dosing in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag183","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T11:42:13Z","timestamp":1778586133000},"source":"Crossref","is-referenced-by-count":0,"title":["Likelihood of aggressive PK\/PD target attainment of continuous-infusion beta-lactams during the first week of treatment of febrile neutropenia: findings from a 1-year prospective, monocentric study in onco-haematological patients"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7135-4410","authenticated-orcid":false,"given":"Pier Giorgio","family":"Cojutti","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna 40138 ,","place":["Italy"]},{"name":"Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Toschi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeno","family":"Pasquini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Paolini","sequence":"additional","affiliation":[{"name":"Institute of Hematology \u2018L. and A. 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