{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:32:51Z","timestamp":1792067571343,"version":"4.4.0"},"reference-count":41,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The anti-tumor response of the immune system is pivotal for treating triple-negative breast cancer (TNBC), particularly as targeted therapies are limited. However, the impact of immune-modulating factors such as the application of granulocyte-stimulating factors (G-CSFs) or infections, including febrile neutropenia, prophylactic or therapeutical application of oral antibiotics (OABs), and the need for intravenous antibiotics (IABs), on survival outcomes remains unclear. Methods: 1583 patients with early-stage TNBC enrolled in the SUCCESS A or C study underwent primary surgery, adjuvant chemotherapy, and radiotherapy if indicated. All patients had Eastern Cooperative Oncology Group (ECOG) status \u2264 2. The effects of G-CSF, OAB, and IAB application on overall survival (OS), invasive disease-free survival (iDFS), breast cancer-specific survival (BCSS), and distant disease-free survival (DDFS) were assessed. Results: Only IAB treatment was significantly associated with decreased survival in univariable analyses (OS: p = 0.003; iDFS: p = 0.036; BCSS: p = 0.011; DDFS: p = 0.044), while G-CSF and OAB administration were not. Adjusted multivariable Cox regressions including febrile neutropenia and dose reduction\/shift, ECOG, age of patients, and other clinicopathological parameters confirmed a significant negative effect of IABs on OS (p = 0.020), BCSS (p = 0.018), and DDFS (p = 0.044). Conclusions: In summary, IABs during adjuvant chemotherapy seems to be a risk factor for inferior OS, BCSS, and DDFS in TNBC patients, possibly by affecting microbiome-related immune response modulation. Hence, preventive measures to avoid the need for IABs should be considered in these patients.<\/jats:p>","DOI":"10.3390\/cancers17091498","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T07:49:36Z","timestamp":1745912976000},"page":"1498","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Negative Effect of Intravenous Antibiotics on Survival in Patients with Triple-Negative Breast Cancer"],"prefix":"10.3390","volume":"17","author":[{"given":"Stefan","family":"Lukac","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Visnja","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1589-2016","authenticated-orcid":false,"given":"Davut","family":"Dayan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Rack","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Janni","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krisztian","family":"Lato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Veselinovic","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Heublein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-8067","authenticated-orcid":false,"given":"Thomas Wolfram Paul","family":"Friedl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-3417","authenticated-orcid":false,"given":"Elena","family":"Leinert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"ref_1","unstructured":"World Health Organisation (2025, February 20). 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