{"corpus_id":34127875,"paper_sha":"50178396e1a20cc8f63de830e2e8fefb71d6c8cd","doi":"10.1007/BF01992162","arxiv_id":null,"pmid":8187783,"pmcid":"7101747","mag_id":2093546045,"dblp_id":null,"acl_id":null,"title":"Strategy for antibiotic therapy in febrile neutropenic patients on selective antibiotic decontamination","year":1993,"publication_date":"1993-12-01","venue":"European Journal of Clinical Microbiology and Infectious Diseases","journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","pages":"897 - 906","volume":"12"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle"],"pubmed_pub_types":["Journal Article"],"s2_fields_of_study":["Medicine"],"reference_count":42,"citation_count":15,"influential_citation_count":0,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Adult","mj":false,"ui":"D000328"},{"d":"Aged","mj":false,"ui":"D000368"},{"d":"Anti-Bacterial Agents","mj":false,"qs":[{"q":"therapeutic use","mj":true,"ui":"Q000627"}],"ui":"D000900"},{"d":"Bacterial Infections","mj":false,"qs":[{"q":"drug therapy","mj":false,"ui":"Q000188"}],"ui":"D001424"},{"d":"Fever","mj":false,"qs":[{"q":"drug therapy","mj":true,"ui":"Q000188"},{"q":"etiology","mj":false,"ui":"Q000209"}],"ui":"D005334"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Middle Aged","mj":false,"ui":"D008875"},{"d":"Mycoses","mj":false,"qs":[{"q":"drug therapy","mj":false,"ui":"Q000188"}],"ui":"D009181"},{"d":"Neutropenia","mj":false,"qs":[{"q":"drug therapy","mj":true,"ui":"Q000188"}],"ui":"D009503"},{"d":"Prospective Studies","mj":false,"ui":"D011446"}],"chemicals":[{"n":"Anti-Bacterial Agents","ui":"D000900","reg":"0"}],"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"https://link.springer.com/content/pdf/10.1007/BF01992162.pdf","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/50178396e1a20cc8f63de830e2e8fefb71d6c8cd","s2_open_access_license":null,"s2_open_access_status":"BRONZE","pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"In a non-randomized prospective study the need for broad-spectrum antibiotic therapy was evaluated in selectively decontaminated neutropenic patients with fever. Fifty-two adult patients with a neutrophil count < 0.5 × 109/l suffered 77 febrile episodes while receiving oral antibiotics for selective decontamination. Antibiotic treatment was only initiated if additional clinical signs or the microbiological culture results pointed to the likelihood of an infection. Treatment was either empirically based (broad-spectrum) or specific (narrow-spectrum). If a causative agent was identified, therapy was adjusted accordingly. If evidence of infection was lacking after 72–96 hours, the antibiotics were discontinued, and these patients were reexamined meticulously and repeatedly. For the 40 episodes without confirmed infection, the median duration of therapy was three days (range 0–13 days) and the survival rate 100 %; for the 37 episodes with confirmed infection, the median duration of therapy was 12 days (range 1–49 days, p<0.0001) and the survival rate 85 %. After adjustment of therapy the final regimen was broad-spectrum in only 18 % of treated episodes. None of the six deaths could be attributed to the withholding or stopping of broad-spectrum therapy. It is concluded that in febrile neutropenic patients on selective decontamination a standard therapy regimen with prolonged administration of broad-spectrum antibiotics is not necessary. After initial intervention antibiotic therapy can safely be tailored to the needs of the individual patient.","claims":[{"public_id":"cl_99423ae867519c8e60e5073152f9c75a","status":"active","text":"A standard regimen with prolonged broad-spectrum antibiotic administration is not necessary for febrile neutropenic patients receiving selective decontamination.","confidence":0.98,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_99423ae867519c8e60e5073152f9c75a"},{"public_id":"cl_5bfacaa9f59ef6c95ecf5edd279e8668","status":"active","text":"After initial intervention, antibiotic therapy can be safely tailored to the needs of the individual patient.","confidence":0.96,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_5bfacaa9f59ef6c95ecf5edd279e8668"},{"public_id":"cl_b1ccd5fb1f79a393d7928f95cccfe40c","status":"active","text":"In episodes with confirmed infection, treatment lasted a median of 12 days and survival was 85%.","confidence":0.93,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_b1ccd5fb1f79a393d7928f95cccfe40c"},{"public_id":"cl_77f00bc6ab17db90eebabab90a0fb05d","status":"active","text":"In episodes without confirmed infection, antibiotics were stopped after 72–96 hours, with a median treatment duration of three days and 100% survival.","confidence":0.94,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_77f00bc6ab17db90eebabab90a0fb05d"},{"public_id":"cl_bb2a57e9c9770656e0b7edab5be1a910","status":"active","text":"The final regimen was broad-spectrum in only 18% of treated episodes after therapy was adjusted to the identified causative agent.","confidence":0.91,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_bb2a57e9c9770656e0b7edab5be1a910"}],"concepts":[{"public_id":"co_095f87c51484ad47ff57ca6e88815853","status":"active","name":"selective antibiotic decontamination","description":"A prophylactic oral antibiotic strategy used to reduce microbial colonization in neutropenic patients.","types":["treatment strategy"],"aliases":["selective decontamination"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_095f87c51484ad47ff57ca6e88815853"},{"public_id":"co_0b07ee0a1a1563d4fc5e15c36b2806d3","status":"active","name":"febrile neutropenic patients","description":"Patients with fever and a markedly reduced neutrophil count.","types":["patient group"],"aliases":["neutropenic patients with fever"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_0b07ee0a1a1563d4fc5e15c36b2806d3"},{"public_id":"co_2338d532a94521a957d11aea76adb1ac","status":"active","name":"broad-spectrum antibiotic therapy","description":"Antibiotic treatment designed to cover a wide range of possible pathogens.","types":["treatment"],"aliases":["broad-spectrum antibiotics"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_2338d532a94521a957d11aea76adb1ac"},{"public_id":"co_38d5e42967305fc85fd45a38d1d76bce","status":"active","name":"confirmed infection","description":"An episode in which microbiological or clinical evidence supports the presence of infection.","types":["diagnostic status"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_38d5e42967305fc85fd45a38d1d76bce"},{"public_id":"co_5988aa14879d4b278905d2feafe3dfa6","status":"active","name":"antibiotic therapy","description":"Administration of antibiotics to treat or prevent infection.","types":["treatment"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_5988aa14879d4b278905d2feafe3dfa6"},{"public_id":"co_5c58e078b1789934463250e03331c34b","status":"active","name":"survival rate","description":"The proportion of episodes or patients who survived the observed treatment period.","types":["outcome measure"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_5c58e078b1789934463250e03331c34b"},{"public_id":"co_9f305afd6527c3339bd97f92d4b2eb33","status":"active","name":"individual patient tailoring","description":"Adjusting treatment based on the clinical and microbiological needs of a specific patient.","types":["treatment approach"],"aliases":["tailored therapy"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_9f305afd6527c3339bd97f92d4b2eb33"},{"public_id":"co_d55bbaf2d85c0cb2dede78b0ae8543ab","status":"active","name":"antibiotics","description":"Drugs used to treat bacterial infection in the febrile neutropenic episodes described.","types":["drug class"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_d55bbaf2d85c0cb2dede78b0ae8543ab"},{"public_id":"co_f5dfa16be685a2ffa79b317de983d9a4","status":"active","name":"causative agent","description":"The infectious organism identified as the source of the febrile episode.","types":["pathogen"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_f5dfa16be685a2ffa79b317de983d9a4"},{"public_id":"co_fbfb404c48975bbd055fbdb327032227","status":"active","name":"initial intervention","description":"The first antibiotic decision or treatment step taken when fever occurs.","types":["clinical step"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_fbfb404c48975bbd055fbdb327032227"}],"external_ids":{"DOI":"10.1007/BF01992162","ArXiv":null,"PubMed":8187783,"PubMedCentral":"7101747","MAG":2093546045,"DBLP":null,"ACL":null},"open_access":{"is_open_access":true,"pdf_url":"https://link.springer.com/content/pdf/10.1007/BF01992162.pdf","landing_url":"https://www.semanticscholar.org/paper/50178396e1a20cc8f63de830e2e8fefb71d6c8cd","source":"semantic_scholar","pdf_url_source":"semantic_scholar_open_access_pdf","license":null,"status":"BRONZE","reason":null},"reference_availability":{"status":"available","references_indexed":true,"full_text_available":false,"full_text_source":null,"count_basis":"semantic_scholar_metadata","extraction_status":"not_applicable","reason":null},"source":{"provider":"episteme2","base_corpus":"semantic_scholar_dump","freshness_mode":"unknown","basis":["semantic_scholar_metadata","postgres_metadata"],"limits":["paper metadata is based on indexed upstream scholarly datasets","claims and concepts are available only for extracted papers","absence of claims or concepts means no extracted graph data is available in this response"],"status":"available","degraded":false,"degraded_reasons":[],"diagnostics":{"status":"available","degraded":false,"degraded_reasons":[],"metadata_status":"available","graph_status":"available","abstract_status":"available"},"source_flags":5},"paper_id":634936,"paper_uid":"a93f7f30-3384-4bdb-8028-593a6aa42f49","canonical_identity":{"paper_id":634936,"paper_uid":"a93f7f30-3384-4bdb-8028-593a6aa42f49","identity_status":"available","lookup_basis":"semantic_scholar_external_id","compatibility_path":"corpus_id"},"url":"https://sah.borca.ai/papers/34127875"}