{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T07:04:09Z","timestamp":1778569449240,"version":"3.51.4"},"reference-count":120,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The emergence of antibiotic resistance poses a global health threat. High-risk patients such as those with neutropenia are particularly vulnerable to opportunistic infections, sepsis, and multidrug-resistant infections, and clinical outcomes remain the primary concern. Antimicrobial stewardship (AMS) programs should mainly focus on optimizing antibiotic use, decreasing adverse effects, and improving patient outcomes. There is a limited number of published studies assessing the impact of AMS programs on patients with neutropenia, where early appropriate antibiotic choice can be the difference between life and death. This narrative review updates the current advances in strategies of AMS for bacterial infections among high-risk patients with neutropenia. Diagnosis, drug, dose, duration, and de-escalation (5D) are the core variables among AMS strategies. Altered volumes of distribution can make standard dose regimens inadequate, and developing skills towards a personalized approach represents a major advance in therapy. Intensivists should partner antibiotic stewardship programs to improve patient care. Assembling multidisciplinary teams with trained and dedicated professionals for AMS is a priority.<\/jats:p>","DOI":"10.3390\/microorganisms11051127","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T04:42:54Z","timestamp":1682484174000},"page":"1127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-9474","authenticated-orcid":false,"given":"Joana","family":"Alves","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Hospital de Braga, 4710-243 Braga, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bet\u00e2nia","family":"Abreu","sequence":"additional","affiliation":[{"name":"Pharmaceuticals Department, Hospital de Braga, 4710-243 Braga, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3698-1037","authenticated-orcid":false,"given":"Pedro","family":"Palma","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Centro Hospitalar do T\u00e2mega e Sousa, 4564-007 Penafiel, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emine","family":"Alp","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Clinical Microbiology Department, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06760 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarsila","family":"Vieceli","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre 90035-903, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0676-6210","authenticated-orcid":false,"given":"Jordi","family":"Rello","sequence":"additional","affiliation":[{"name":"Clinical Research in Pneumonia & Sepsis (CRIPS), Vall d\u2019Hebron Institute of Research (VHIR), 08035 Barcelona, Spain"},{"name":"FOREVA Research P\u00f4le, Centre H\u00f4pitalaire Universitaire de N\u00eemes, 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1188\/16.CJON.281-288","article-title":"Implementing the Surviving Sepsis Campaign in an Ambulatory Clinic for Patients with Hematologic Malignancies","volume":"20","author":"Shelton","year":"2016","journal-title":"Clin. 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