Short versus extended treatment with a carbapenem in patients with high-risk fever of unknown origin during neutropenia: a non-inferiority, open-label, multicentre, randomised trial
- de Jonge, Nick A.
- Sikkens, Jonne J.
- Zweegman, Sonja
- Beeker, Aart
- Ypma, Paula
- Herbers, Alexandra H.
- Vasmel, Wies
- de Kreuk, Arne
- Coenen, Juleon L. L. M.
- Lissenberg-Witte, Birgit
- Kramer, Mark H. H.
- van Agtmael, Michiel A.
- Janssen, Jeroen J. W. M.
DOIAbstract
Background: Early antibiotic discontinuation has been advocated in haematology patients with fever of unknown origin during chemotherapy-induced neutropenia, but its safety is unknown. We aimed to assess if short treatment with carbapenems is non-inferior to extended treatment. Methods: This non-inferiority, open-label, multicentre, randomised trial was done in six hospitals in the Netherlands. Adult patients (≥18 years) who were treated with intensive chemotherapy or haematopoietic stem-cell transplantation (HSCT) for a haematological malignancy, and had fever of unknown origin during high-risk neutropenia (<0·5 × 10 9/L expected for ≥7 days) were eligible. After onset of fever, patients received either 500 mg intravenous imipenem-cilastat...
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