{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:39:28Z","timestamp":1780321168544,"version":"3.54.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rapid antibiotic initiation is essential for managing potential infections following chemotherapy-induced neutropenia. However, excessive use of broad-spectrum antibiotics should be avoided. Implementing antimicrobial stewardship (AMS) in haematology units is challenging due to high infection-related risks, and data on interventions remain scarce. This study aimed to evaluate the safety of an AMS bundle on a haematology ward.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted at a tertiary care centre among patients with high-risk (\u22657\u2005days) neutropenia. The AMS bundle consisted of replacing empirical meropenem with ceftazidime, and shortening treatment duration to 2\u2005days in case of defervescence and negative blood cultures. Data on ICU admission, all-cause mortality, antimicrobial use and microorganisms identified were compared with a (retrospective) pre-intervention cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 396 patients were included (206 pre-intervention, 190 post-intervention). Allogeneic stem cell transplantations increased from 21% pre-intervention to 37% post-intervention. There was no statistical difference in the adjusted composite endpoint of ICU admission and all-cause mortality [adjusted HR (aHR) 1.46; 95% CI, 0.76\u20132.81; P\u200a=\u200a0.26]. Pre-intervention, meropenem was prescribed in 99% of patients, which shifted to ceftazidime in 78% post-intervention. Median antibiotic treatment duration decreased from 8.0 to 5.0\u2005days (P &amp;lt; 0.001), and empirical antibiotic consumption decreased from 12 to 8\u2005days of therapy per patient (P &amp;lt; 0.001). Bloodstream infections with Candida spp. decreased from 17 pre-intervention to 5 post-intervention (P\u200a=\u200a0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The AMS bundle led to a shift towards narrower-spectrum antibiotics, and reduced treatment duration and overall antibiotic use without a significant impact on the primary safety outcome. The intervention was accompanied by a declining trend in candidaemia incidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf191","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:12:44Z","timestamp":1759320764000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of an antimicrobial stewardship bundle on the outcome of high-risk neutropenic patients with fever: a pre-post study"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6821-0405","authenticated-orcid":false,"given":"Suzanne M E","family":"Kuijpers","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, Amsterdam Institute for Infection and Immunity , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jara R","family":"de la Court","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, Amsterdam Institute for Infection and Immunity , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5415-8933","authenticated-orcid":false,"given":"Jan M","family":"Prins","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, Amsterdam Institute for Infection and Immunity , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogier P","family":"Schade","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9615-7851","authenticated-orcid":false,"given":"Jarom","family":"Heijmans","sequence":"additional","affiliation":[{"name":"Department of Haematology, Amsterdam UMC, University of Amsterdam , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim C E","family":"Sigaloff","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, Amsterdam Institute for Infection and Immunity , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"2025102113332778800_dlaf191-B1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s00277-007-0390-7","article-title":"Compliance with a critical pathway for the management of febrile 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