6/29/23, 11:42 PM SHORT Pathway Feedback Search Clinical Topics Home Studies SHORT SHORT Disease Febrile neutropenia Trial question Is short antibiotic treatment noninferior to extended antibiotic treatment with carbapenems in patients with high-risk fever of unknown origin during chemotherapy-induced neutropenia? Study design Multi-center Open label RCT Population Characteristics of study participants 39.0% female N = 281 61.0% male 281 patients (109 female, 172 male) Inclusion criteria: adult patients who had fever of unknown origin during high-risk neutropenia and were treated for hematological malignancy Key exclusion criteria: contraindication to use of imipenem-cilastatin or meropenem; corticosteroid use 10 mg/day prednisolone or equivalent for > 3 consecutive day during the previous 7 days; infection; symptoms of septic shock Interventions N=144 short treatment (500 mg intravenous imipenem-cilastatin QID or 1,000 mg intravenous meropenem TID for 72 hours) https://web.pathway.md/studies/recQt8lZcKWp1ZR6P 1/2 6/29/23, 11:42 PM SHORT Pathway N=137 extended treatment (500 mg intravenous imipenem-cilastatin QID or 1,000 mg intravenous meropenem TID for 9 days) Primary outcome Carbapenem -sensitive infection or recurrent fever 19.0 % 19 15 14.3 % 9.5 % Difference not exceeding nonferiority margin 4.8 % 0.0 % Short treatment Extended treatment Difference not exceeding nonferiority margin in carbapenem -sensitive infection or recurrent fever (19% vs. 15%; AD 4%, 90% CI -1.7 to 9.7) Secondary outcomes Significant increase in the rate of death within 30 days after the end of neutropenia (3% vs. 1%; AD 2.6%, 95% CI 1.2 to 4.1) Safety outcomes Significant difference in serious adverse events (16% vs. 10%). Conclusion In adult patients who had fever of unknown origin during high-risk neutropenia and were treated for hematological malignancy, short treatment was noninferior to extended treatment with respect to carbapenem -sensitive infection or recurrent fever. Reference Nick A de Jonge, Jonne J Sikkens, Sonja Zweegman et al. 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. Lancet Haematol. 2022 Jun 9;S2352-3026(22)00145-4. Open reference URL https://web.pathway.md/studies/recQt8lZcKWp1ZR6P 2/2