{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:08:37Z","timestamp":1787018917606,"version":"build-2736575974"},"reference-count":9,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>Background: Patients with hematologic malignancies frequently develop febrile neutropenia (FN) and subsequently receive long courses of broad-spectrum antibiotics. Limited data is available on de-escalation strategies. Methods: This was a retrospective observational cohort study of adult patients with a hematologic malignancy, FN, and positive culture results from June 2017 to June 2020. A conventional group (patients who remained on empiric, broad-spectrum agents) was compared to a de-escalation group (patients whose antibiotic therapy was de-escalated based on culture results). The primary outcome was the incidence of recurrent fever or antibiotic escalation due to infection while neutropenic. Results: Of the 123 patients included, the composite primary outcome occurred in 35.3% in the de-escalation group and 39.3% in the conventional group ( P = .83). For secondary outcomes, median time to recurrent fever was 7\u00a0days in the de-escalation group and 7\u00a0days in the conventional group ( P = .73). Incidence of Clostridioides difficile was 5.9% in the de-escalation group and 6.7% in the conventional group ( P = 1.00). Development of multidrug resistant pathogens during hospital admission was 20.6% in the de-escalation group and 14.6% in the conventional group ( P = .59). Median length of broad-spectrum antibiotics was 3\u00a0days in the de-escalation group and 8\u00a0days in the conventional group ( P &lt; .001). All-cause mortality within 30 days was 0 in the de-escalation group and 5.6% in the conventional group ( P = .32). Conclusion: In a small sample of patients with a hematologic malignancy and FN, de-escalating antibiotics based on positive cultures decreased the duration of antibiotic therapy without increasing the rate of antibiotic failure.<\/jats:p>","DOI":"10.1177\/08971900221132120","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T11:13:15Z","timestamp":1665054795000},"page":"301-306","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes Associated with De-escalation of Antibiotics to Target Positive Cultures when Treating Febrile Neutropenia"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6815-8048","authenticated-orcid":false,"given":"Rebecca","family":"Rainess","sequence":"first","affiliation":[{"name":"Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Santamala","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine J.","family":"Kubin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"bibr1-08971900221132120","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir073"},{"key":"bibr2-08971900221132120","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6211"},{"key":"bibr3-08971900221132120","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.091769"},{"key":"bibr4-08971900221132120","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Prevention and Treatment of Cancer-Related Infections","author":"Baden LR"},{"key":"bibr5-08971900221132120","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.091025"},{"key":"bibr6-08971900221132120","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-022-01084-0"},{"key":"bibr7-08971900221132120","doi-asserted-by":"publisher","DOI":"10.1177\/1078155215597558"},{"key":"bibr8-08971900221132120","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12445"},{"key":"bibr9-08971900221132120","first-page":"1","author":"Alegria W","year":"2022","journal-title":"J Natl Compr Canc Netw"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900221132120","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900221132120","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900221132120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:37:54Z","timestamp":1777509474000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900221132120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,6]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1177\/08971900221132120"],"URL":"https:\/\/doi.org\/10.1177\/08971900221132120","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,6]]}}}