{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:13:16Z","timestamp":1779383596513,"version":"3.53.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Aims<\/jats:title>\n                    <jats:p>To assess the effectiveness of an antimicrobial stewardship (AMS) intervention in haematology patients with febrile neutropenia (FN) on days of therapy (DOT) of empiric broad\u2010spectrum antibiotic therapy (EBAT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010centre, prospective cohort study of adult haematology patients admitted with FN from 1 May to 30 November 2022, compared with a retrospective cohort of patients admitted from 1 January 2018 to 31 December 2021. AMS intervention involved infectious diseases advice at weekly haematology meetings to encourage cessation of EBAT for patients with FN who were clinically stable with no isolated source. Primary outcome was duration and agent of EBAT DOT for patients without an identifiable source of fever.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      For FN without an identifiable infective source, mean DOT was significantly shorter (7.1 vs 5.0\u2009days (\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.04)). There was also a significant increase in the number of patients for whom EBAT was ceased prior to neutrophil recovery in the prospective cohort (40% vs 61%,\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.016). For patients without an identified source, duration of piperacillin\u2010tazobactam and meropenem therapy decreased from 2018\u20132021 to 2022, with a trend towards significance (6.1 vs 4.4,\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.07; 12.7 vs 4.4,\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.07 respectively). There was no increase in recurrence of fever, antibiotic escalation, intensive care unit admission or death within 30\u2009days in the post\u2010intervention group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>We demonstrate that an AMS intervention decreased EBAT duration for patients without a source of infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70330","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:27:48Z","timestamp":1768382868000},"page":"803-810","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early de\u2010escalation of broad\u2010spectrum antibiotic therapy in febrile neutropenia"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9499-0292","authenticated-orcid":false,"given":"Alyssa","family":"Pradhan","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Prince of Wales Hospital  Randwick New South Wales Australia"},{"name":"Department of Infectious Diseases Westmead Hospital  Westmead New South Wales Australia"},{"name":"Sydney Infectious Diseases Institute and Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annmarie","family":"Bosco","sequence":"additional","affiliation":[{"name":"Department of Haematology Prince of Wales Hospital  Randwick New South Wales Australia"},{"name":"University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Beardsley","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Westmead Hospital  Westmead New South Wales Australia"},{"name":"Sydney Infectious Diseases Institute and Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Yuen","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Prince of Wales Hospital  Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2955"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.091025"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028019890886"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000380"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir073"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2010.02340.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(17)30211-9"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2018.1438649"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078155219865303"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100855"},{"key":"e_1_2_10_13_1","article-title":"Safety and efficacy of antibiotic De\u2010escalation and discontinuation in high\u2010risk hematological patients with febrile neutropenia: a single\u2010center experience","volume":"9","author":"Verlinden A","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-022-01084-0"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-018-3328-1"},{"key":"e_1_2_10_16_1","first-page":"Cd012184","article-title":"Early discontinuation of antibiotics for febrile neutropenia versus continuation until neutropenia resolution in people with cancer","volume":"1","author":"Stern A","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_17_1","volume-title":"National Statement on Ethical Conduct in Human Research, A.R.C.A.U. 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