SynthesisAntimicrobial agents and chemotherapy2025
Efficacy and safety of early antibiotic de-escalation in febrile neutropenia for patients with hematologic malignancy: a systematic review and meta-analysis.
Synthesis in Antimicrobial agents and chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Improving Empiric Antibiotic Selection for Patients With Cancer Hospitalized With Infection: Secondary Analysis of the INSPIRE Cluster Randomized Trials.JAMA network open · 2026Trial
- Interpreting Glycopeptide Escalation and Acute Kidney Injury with CautionTurkish journal of haematology : official journal of Turkish Society of Haematology · 2026Article
- Incidence proportion and divergent performance of risk factors for carbapenem-resistant Gram-negative bacteria bloodstream infections across haematological cohorts.JAC-antimicrobial resistance · 2026Article
- Antimicrobial use in pediatric hematopoietic stem cell transplantation in China: a retrospective multicenter cohort study.BMC pediatrics · 2026Observational
- The Analysis of Missed Antibiotic De-Escalation Opportunities in Gram-Negative Bloodstream Infections.Antibiotics (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
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Abstract
Febrile neutropenia (FN) is a serious complication in patients with hematologic malignancies following treatments such as chemotherapy and hematopoietic stem cell transplantation. It is typically managed with broad-spectrum antibiotics (BSA), but the optimal duration of BSA therapy remains controversial. This meta-analysis aimed to assess the clinical efficacy and safety of early antibiotic de-escalation in patients with hematologic malignancies with FN before hematopoietic recovery, compared to those who continued BSA until hematopoietic recovery. Statistical analysis included pooled odds ratios (OR) for mortality and secondary adverse outcomes, along with subgroup analysis to identify patient populations that may benefit from early de-escalation. Ten studies, mostly retrospective observational designs, were included. Early de-escalation significantly reduced mortality risk (OR 0.20, 95% CI 0.06-0.69). Subgroup analyses showed mortality benefits in older patients (>55 years old, OR 0.42, 95% CI 0.18-0.98) and in higher-quality studies (OR 0.07, 95% CI 0.01-0.62). No significant differences were observed for infection-related ICU admissions, bacteremia, recurrent fever, or
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