{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T20:42:37Z","timestamp":1791751357774,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the management of Gram\u2010negative bloodstream infection (GN\u2010BSI), short antimicrobial courses have been increasingly demonstrated to be non\u2010inferior to prolonged therapy, with lower risk of <jats:italic>Clostridioides difficile<\/jats:italic> infection (CDI) and emergence of multi\u2010drug resistant (MDR) organisms. However, immunocompromised hosts were excluded from these studies. We investigated outcomes of short (\u226410 days), intermediate (11\u201314 days), and prolonged (\u226515 days) antimicrobial durations for GN\u2010BSI in neutropenic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted on neutropenic patients with monomicrobial GN\u2010BSI between 2018 and 2022. The primary outcome was a composite of all\u2010cause mortality and microbiologic relapse within 90 days after therapy completion. The secondary outcome was a composite of 90\u2010day CDI and development of MDR\u2010GN bacteria. Cox regression analysis with propensity score (PS) adjustment was used to compare outcomes between the three groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 206 patients were classified into short (<jats:italic>n<\/jats:italic> = 67), intermediate (<jats:italic>n<\/jats:italic> = 81), or prolonged (<jats:italic>n<\/jats:italic> = 58) duration. Neutropenia was predominantly secondary to hematopoietic stem cell transplantation (48%) or hematologic malignancy (35%). The primary sources of infection included intra\u2010abdominal (51%), vascular catheter (27%), and urinary (8%). Most patients received definitive therapy with cefepime or carbapenem. No significant difference in the primary composite endpoint was observed for intermediate versus short (PS\u2010adjusted hazard ratio [aHR] 0.89; 95% confidence interval [95% CI] 0.39\u20132.03) or prolonged versus short therapy (PS\u2010aHR 1.20; 95% CI 0.52\u20132.74). There was no significant difference in the secondary composite endpoint of CDI or MDR\u2010GN emergence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data suggest that short antimicrobial courses had comparable 90\u2010day outcomes as intermediate and prolonged regimens for GN\u2010BSI among immunocompromised patients with neutropenia.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14085-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14085","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T13:01:13Z","timestamp":1686142873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Evaluating antimicrobial duration for Gram\u2010negative bacteremia in patients with neutropenia due to hematologic malignancy or hematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"25","author":[{"given":"Nischal","family":"Ranganath","sequence":"first","affiliation":[{"name":"Division of Public Health Infectious Diseases, and Occupational Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary A.","family":"Yetmar","sequence":"additional","affiliation":[{"name":"Division of Public Health Infectious Diseases, and Occupational Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey R.","family":"McCandless","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina G.","family":"Rivera","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D.","family":"Lahr","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials &amp; Biostatistics Department of Quantitative Health Sciences College of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron J.","family":"Tande","sequence":"additional","affiliation":[{"name":"Division of Public Health Infectious Diseases, and Occupational Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Public Health Infectious Diseases, and Occupational Medicine Mayo Clinic  Rochester Minnesota 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