Early Neutropenic Fever De-escalation of Antibiotics Study
This is a randomized, open label clinical trial among individuals with hematologic conditions. The trial aims to evaluate the safety and clinical outcomes of de-escalating antibiotic therapy among stable individuals diagnosed with neutropenic fever, in which no bacterial infection has been identified.
- EligibilityCriteria: Inclusion Criteria:  Participant or healthcare proxy with the ability to understand and willingness to sign an informed consent. Adults >18 years old. Likely to have neutropenia > 7 days including such conditions as: acute leukemia; lymphoproliferative disease; multiple myeloma; myelodysplastic syndrome; bone marrow aplasia and autologous or allogeneic hematopoietic stem cell transplantation. Neutropenia defined as absolute neutrophil count <500. Received or planned to receive cytotoxic chemotherapy. No restrictions on prior therapy regarding dose or agent. High-risk neutropenia defined as expected duration of absolute neutrophil count less than 500 cells/µL for seven or more days. Admitted as an inpatient at Mass General Brigham or Dana Farber Cancer Institute (DFCI). Initial fever (defined as a single oral temperature of ≥38.3°C or a temperature of ≥38.0°C sustained over a one-hour period) during hospital admission or as reason for admission. Has been afebrile for 48 hours.  Exclusion Criteria:  Microbiologically or clinically suspected bacterial infection after index fever. Exposure to treatment antibacterial therapy 72 hours before first fever occurrence other than antibiotics deemed as prophylaxis. - HealthyVolunteers: No - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult