{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:21:50Z","timestamp":1787649710548,"version":"build-2736575974"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Vancomycin is still frequently started empirically in febrile neutropaenia, especially when patients are severely ill. Yet randomized evidence concerning anti-Gram-positive agents as a class shows no mortality benefit from routine empirical coverage, and contemporary cohort studies consistently link early shock and death to Gram-negative bacilli, inadequate Gram-negative coverage, pneumonia, septic shock and candidaemia rather than to Gram-positive bacteraemia or inadequate Gram-positive coverage. MRSA nasal screening further supports avoiding empirical anti-MRSA therapy in screen-negative patients. The default response to febrile neutropaenia should therefore be rapid, locally informed anti-pseudomonal beta-lactam therapy, with vancomycin reserved for documented infection or narrowly defined syndromes with a high pre-test probability of resistant Gram-positive disease.<\/jats:p>","DOI":"10.1093\/jac\/dkag294","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:16:23Z","timestamp":1786706183000},"source":"Crossref","is-referenced-by-count":0,"title":["Is there any role for empiric coverage of resistant Gram-positive bacteria in febrile neutropaenia?"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4867-0014","authenticated-orcid":false,"given":"Marcio","family":"Nucci","sequence":"first","affiliation":[{"name":"Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (HUCFF-CH-UFRJ HUBrasil) , Rua Prof. Rodolpho Paulo Rocco 255, Sala 4A12, Rio de Janeiro 21941-913 ,","place":["Brazil"]},{"name":"Department of Hematology, Grupo Oncoclinicas , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone A","family":"Nou\u00e9r","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (HUCFF-CH-UFRJ HUBrasil) , Rua Prof. Rodolpho Paulo Rocco 255, Sala 4A12, Rio de Janeiro 21941-913 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"2026082504494303800_dkag294-B1","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1056\/NEJM197105132841904","article-title":"Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia","volume":"284","author":"Schimpff","year":"1971","journal-title":"N Engl J 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