{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T20:28:11Z","timestamp":1768249691377,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2006,12,12]],"date-time":"2006-12-12T00:00:00Z","timestamp":1165881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2007,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background: <\/jats:bold> International guidelines recommend routine microbiological assessment of patients with febrile neutropenia, but do not recommend a change from broad\u2010spectrum antibiotic therapy to pathogen\u2010specific therapy when a clinically relevant organism has been isolated. The aim of the study was to determine the aetiology of febrile neutropenia in adult haematology patients at Auckland City Hospital, to document the changes in treatment made following isolation of a clinically relevant organism and to assess adverse outcomes in any patient who received pathogen\u2010specific therapy after a positive culture result.<\/jats:p><jats:p><jats:bold>Methods: <\/jats:bold> The results of all microbiological tests together with antibiotic therapy were recorded from consecutive patients with fever and a neutrophil count &lt;0.5\u2003\u00d7\u200310<jats:sup>9<\/jats:sup>\/L over 1\u2003year beginning in May 2003.<\/jats:p><jats:p><jats:bold>Results: <\/jats:bold> One thousand one hundred and ninety\u2010six specimens were collected from 81 patients during 116 episodes of febrile neutropenia. A pathogen was isolated from blood cultures in 40 episodes: Gram\u2010positive cocci accounted for 46% of isolates and Gram\u2010negative bacilli for 35%. Isolation of a pathogen from blood cultures resulted in a change of treatment in 25 of 40 (62.5%, 95%CI 46\u201377%) episodes. In 12 of these episodes, antibiotic therapy was optimized to a single pathogen\u2010specific agent. No adverse events or subsequent changes in antibiotic therapy occurred in any of these 12 patients. Isolation of a pathogen from specimens other than blood seldom led to a change in therapy.<\/jats:p><jats:p><jats:bold>Conclusion: <\/jats:bold> Isolation of a pathogen from blood cultures often allows antibiotic therapy to be simplified to a pathogen\u2010specific regimen. Further study of this approach is warranted.<\/jats:p>","DOI":"10.1111\/j.1445-5994.2006.01239.x","type":"journal-article","created":{"date-parts":[[2006,12,13]],"date-time":"2006-12-13T14:06:31Z","timestamp":1166018791000},"page":"26-31","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["High\u2010risk febrile neutropenia in Auckland 2003\u20132004: the influence of the microbiology laboratory on patient treatment and the use of pathogen\u2010specific therapy"],"prefix":"10.1111","volume":"37","author":[{"given":"S.","family":"Ritchie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Ellis\u2010Pegler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,12,12]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197105132841904"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(72)90567-3"},{"key":"e_1_2_5_4_2","doi-asserted-by":"crossref","unstructured":"The EORTC International Antimicrobial Therapy Project Group.Three antibiotic regimens in the treatment of infection in febrile granulocytopenic patients with cancer.J Infect Dis1978;137:14\u201329.","DOI":"10.1093\/infdis\/137.1.14"},{"key":"e_1_2_5_5_2","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1200\/JCO.1983.1.10.597","article-title":"Combination of amikacin and carbenicillin with or without cefazolin as empirical treatment of febrile neutropenic patients","volume":"1","author":"The International Antimicrobial Therapy Project Group of the EORTC","year":"1983","journal-title":"J Clin Oncol"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.29.2.263"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1086\/339215"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/383054"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199305063281808"},{"key":"e_1_2_5_10_2","volume-title":"Manual of Clinical Microbiology","author":"Murray P","year":"2003"},{"key":"e_1_2_5_11_2","unstructured":"NCCLS.Performance standards for antimicrobial disk susceptibility tests 8th edn. 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