{"id":"https://openalex.org/W7214073245","doi":"https://doi.org/10.64898/2026.09.22.26363666","title":"Empirical antibacterial use, escalation, microbiological profile, and outcomes in febrile neutropenia: An ambispective observational study","display_name":"Empirical antibacterial use, escalation, microbiological profile, and outcomes in febrile neutropenia: An ambispective observational study","publication_year":2026,"publication_date":"2026-09-23","ids":{"openalex":"https://openalex.org/W7214073245","doi":"https://doi.org/10.64898/2026.09.22.26363666"},"language":"en","primary_location":{"id":"doi:10.64898/2026.09.22.26363666","doi":"https://doi.org/10.64898/2026.09.22.26363666","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.22.26363666","pdf_url":null,"source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nd","license_id":"https://openalex.org/licenses/cc-by-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.64898/2026.09.22.26363666","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5152541576","display_name":"Satish Girish Trivedi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I83878805","display_name":"Armed Forces Medical College","ror":"https://ror.org/05g6w6j42","country_code":"IN","type":"education","lineage":["https://openalex.org/I83878805"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Trivedi Satish Girish","raw_affiliation_strings":["Department of Internal Medicine, Armed Forces Medical College, Pune - 411 040, Maharashtra, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Armed Forces Medical College, Pune - 411 040, Maharashtra, India","institution_ids":["https://openalex.org/I83878805"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5152575064","display_name":"Santosh Kumar Singh","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I83878805","display_name":"Armed Forces Medical College","ror":"https://ror.org/05g6w6j42","country_code":"IN","type":"education","lineage":["https://openalex.org/I83878805"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Suman Kumar","raw_affiliation_strings":["Department of Internal Medicine, Armed Forces Medical College, Pune - 411 040, Maharashtra, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Armed Forces Medical College, Pune - 411 040, Maharashtra, India","institution_ids":["https://openalex.org/I83878805"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5153309202","display_name":"SK Singh","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I83878805","display_name":"Armed Forces Medical College","ror":"https://ror.org/05g6w6j42","country_code":"IN","type":"education","lineage":["https://openalex.org/I83878805"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"SK Singh","raw_affiliation_strings":["Department of Internal Medicine, Armed Forces Medical College, Pune - 411 040, Maharashtra, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Armed Forces Medical College, Pune - 411 040, Maharashtra, India","institution_ids":["https://openalex.org/I83878805"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I83878805"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12172","display_name":"Neutropenia and Cancer Infections","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12172","display_name":"Neutropenia and Cancer Infections","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10150","display_name":"Antifungal resistance and susceptibility","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/febrile-neutropenia","display_name":"febrile neutropenia","score":1.0},{"id":"https://openalex.org/keywords/empirical-antibiotic-therapy","display_name":"empirical antibiotic therapy","score":0.9739999771118164},{"id":"https://openalex.org/keywords/antibiotic-escalation","display_name":"antibiotic escalation","score":0.7720000147819519},{"id":"https://openalex.org/keywords/cefoperazone-sulbactam","display_name":"cefoperazone/sulbactam","score":0.9810000061988831},{"id":"https://openalex.org/keywords/amikacin","display_name":"amikacin","score":0.9800000190734863},{"id":"https://openalex.org/keywords/teicoplanin","display_name":"teicoplanin","score":0.9980000257492065},{"id":"https://openalex.org/keywords/meropenem","display_name":"meropenem","score":0.9959999918937683},{"id":"https://openalex.org/keywords/gram-negative-infections","display_name":"gram-negative bacterial infection","score":0.8389999866485596},{"id":"https://openalex.org/keywords/coinfection","display_name":"co-infection","score":0.7559999823570251},{"id":"https://openalex.org/keywords/invasive-fungal-infections","display_name":"invasive fungal infections","score":0.9480000138282776},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.8600000143051147},{"id":"https://openalex.org/keywords/mortality","display_name":"mortality","score":0.7670000195503235},{"id":"https://openalex.org/keywords/antimicrobial-resistance-patterns","display_name":"antimicrobial resistance patterns","score":0.5249999761581421}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8883000016212463},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.7332000136375427},{"id":"https://openalex.org/C2776703206","wikidata":"https://www.wikidata.org/wiki/Q2731762","display_name":"Teicoplanin","level":5,"score":0.7170000076293945},{"id":"https://openalex.org/C2781413609","wikidata":"https://www.wikidata.org/wiki/Q7308373","display_name":"Regimen","level":2,"score":0.6355000138282776},{"id":"https://openalex.org/C2779375183","wikidata":"https://www.wikidata.org/wiki/Q421670","display_name":"Meropenem","level":4,"score":0.585099995136261},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5526000261306763},{"id":"https://openalex.org/C501593827","wikidata":"https://www.wikidata.org/wiki/Q12187","display_name":"Antibiotics","level":2,"score":0.5152999758720398},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.4729999899864197},{"id":"https://openalex.org/C2778850193","wikidata":"https://www.wikidata.org/wiki/Q3775974","display_name":"Febrile neutropenia","level":4,"score":0.47049999237060547},{"id":"https://openalex.org/C2777427914","wikidata":"https://www.wikidata.org/wiki/Q408529","display_name":"Amikacin","level":3,"score":0.445499986410141},{"id":"https://openalex.org/C2776056953","wikidata":"https://www.wikidata.org/wiki/Q1182511","display_name":"De-escalation","level":2,"score":0.44130000472068787},{"id":"https://openalex.org/C2777063308","wikidata":"https://www.wikidata.org/wiki/Q1435822","display_name":"Neutropenia","level":3,"score":0.42989999055862427},{"id":"https://openalex.org/C3019249092","wikidata":"https://www.wikidata.org/wiki/Q274493","display_name":"Antibacterial agent","level":3,"score":0.4115999937057495},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.4066999852657318},{"id":"https://openalex.org/C2776685102","wikidata":"https://www.wikidata.org/wiki/Q410897","display_name":"Carbapenem","level":3,"score":0.40529999136924744},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.33309999108314514},{"id":"https://openalex.org/C2777050379","wikidata":"https://www.wikidata.org/wiki/Q2552927","display_name":"Cefepime","level":5,"score":0.3149000108242035},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.31470000743865967},{"id":"https://openalex.org/C500440147","wikidata":"https://www.wikidata.org/wiki/Q701216","display_name":"Pharmacotherapy","level":2,"score":0.31220000982284546},{"id":"https://openalex.org/C2780035454","wikidata":"https://www.wikidata.org/wiki/Q8386","display_name":"Drug","level":2,"score":0.2928999960422516},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.2883000075817108},{"id":"https://openalex.org/C114851261","wikidata":"https://www.wikidata.org/wiki/Q12147416","display_name":"Drug resistance","level":2,"score":0.2881999909877777},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.288100004196167},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.28139999508857727},{"id":"https://openalex.org/C2776865356","wikidata":"https://www.wikidata.org/wiki/Q1182681","display_name":"Defined daily dose","level":3,"score":0.2782000005245209},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.273499995470047},{"id":"https://openalex.org/C2780998478","wikidata":"https://www.wikidata.org/wiki/Q5374236","display_name":"Empirical treatment","level":3,"score":0.27079999446868896},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.2524000108242035}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.09.22.26363666","doi":"https://doi.org/10.64898/2026.09.22.26363666","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.22.26363666","pdf_url":null,"source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nd","license_id":"https://openalex.org/licenses/cc-by-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.09.22.26363666","doi":"https://doi.org/10.64898/2026.09.22.26363666","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.22.26363666","pdf_url":null,"source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nd","license_id":"https://openalex.org/licenses/cc-by-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":7,"referenced_works":["https://openalex.org/W2128842087","https://openalex.org/W2337937901","https://openalex.org/W2520127373","https://openalex.org/W2992250822","https://openalex.org/W3008674077","https://openalex.org/W3097026439","https://openalex.org/W4407011076"],"related_works":["https://openalex.org/W2132986533","https://openalex.org/W7122365356","https://openalex.org/W7155609037","https://openalex.org/W1499092497","https://openalex.org/W7202285022","https://openalex.org/W2148484427","https://openalex.org/W2952165266","https://openalex.org/W4415935230","https://openalex.org/W2585451348","https://openalex.org/W3006439519"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Febrile":[2],"neutropenia":[3],"requires":[4],"rapid":[5],"empirical":[6],"antibiotic":[7],"therapy,":[8],"with":[9,160,168,181,203],"regimen":[10,67],"selection":[11],"shaped":[12],"by":[13],"local":[14],"prescribing":[15],"practice":[16],"and":[17,29,49,81,106,133,149,162,206],"pathogen":[18],"patterns.":[19],"We":[20],"described":[21],"starting":[22,64],"treatment,":[23],"later":[24,66],"drug":[25],"changes,":[26],"microbiological":[27],"findings,":[28],"inpatient":[30],"outcomes.":[31],"Methods":[32],"This":[33],"ambispective":[34],"cohort":[35],"comprised":[36,192],"96":[37,188],"episodes":[38,112],"from":[39],"90":[40],"patients":[41],"admitted":[42],"to":[43],"a":[44,115,199],"tertiary-level":[45],"teaching":[46],"hospital.":[47],"Treatment":[48],"outcome":[50],"analyses":[51],"used":[52],"each":[53],"episode":[54],"as":[55,76],"the":[56,63,146,153,210],"unit":[57],"of":[58,140,187],"observation.":[59],"Recorded":[60],"variables":[61],"included":[62],"antibiotics,":[65],"modification,":[68],"microbiology,":[69],"hospitalization":[70,205],"length,":[71],"invasive":[72],"fungal":[73],"infection":[74],"(IFI)":[75],"captured":[77],"in":[78,93,99,103,108,145,152,185],"study":[79],"records,":[80],"disposition.":[82],"Comparisons":[83],"based":[84],"on":[85],"escalation":[86,147,161,183],"status":[87],"were":[88,136],"exploratory.":[89],"Result":[90],"Cefoperazone-sulbactam":[91],"appeared":[92],"62/96":[94],"initial":[95],"regimens":[96],"(64.6%),":[97],"amikacin":[98],"42":[100],"(43.8%),":[101],"teicoplanin":[102],"28":[104],"(29.2%),":[105],"meropenem":[107],"14":[109],"(14.6%).":[110],"Eighteen":[111],"(18.8%)":[113],"required":[114,184],"change":[116],"that":[117],"broadened":[118],"or":[119,218],"substituted":[120],"antibacterial":[121],"therapy.":[122],"Among":[123],"31":[124],"microbiologically":[125,194],"documented":[126],"infections,":[127],"22":[128],"(71.0%)":[129],"yielded":[130],"Gram-negative":[131,190],"organisms":[132,191],"9":[134,150],"(29.0%)":[135],"polymicrobial.":[137],"Median":[138],"length":[139],"admission":[141],"was":[142,157],"18.5":[143],"days":[144,151],"group":[148],"remainder":[154],"(p<0.001).":[155],"Mortality":[156],"27.8%":[158],"(5/18)":[159],"5.1%":[163],"(4/78)":[164],"without":[165],"it":[166],"(p=0.011),":[167],"nine":[169],"inhospital":[170],"deaths":[171],"overall":[172],"(9.4%).":[173],"Conclusion":[174],"Antibacterial":[175],"management":[176],"differed":[177],"within":[178],"this":[179],"cohort,":[180],"treatment":[182],"18":[186],"episodes.":[189],"most":[193],"confirmed":[195],"infections.":[196],"Escalation":[197],"marked":[198],"clinically":[200],"complex":[201],"course":[202],"prolonged":[204],"greater":[207],"observed":[208],"mortality;":[209],"observational":[211],"design":[212],"does":[213],"not":[214],"establish":[215],"comparative":[216],"efficacy":[217],"causation.":[219]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-09-24T00:00:00"}
