dc.contributor.author | Coyle, V | |
dc.contributor.author | Forde, C | |
dc.contributor.author | McAuley, DF | |
dc.contributor.author | Wilson, RH | |
dc.contributor.author | Clarke, M | |
dc.contributor.author | Plummer, R | |
dc.contributor.author | Grayson, M | |
dc.contributor.author | McDowell, C | |
dc.contributor.author | Agus, A | |
dc.contributor.author | Doran, A | |
dc.contributor.author | Thomas, AL | |
dc.contributor.author | Barnes, RA | |
dc.contributor.author | Adams, R | |
dc.contributor.author | Chau, I | |
dc.contributor.author | Storey, D | |
dc.contributor.author | McMullan, R | |
dc.contributor.author | EASI-SWITCH Investigators, | |
dc.coverage.spatial | England | |
dc.date.accessioned | 2023-10-20T13:25:44Z | |
dc.date.available | 2023-10-20T13:25:44Z | |
dc.date.issued | 2023-07-28 | |
dc.identifier | S1198-743X(23)00349-X | |
dc.identifier.citation | Clinical Microbiology and Infection, 2023, pp. S1198-743X(23)00349-X - | |
dc.identifier.issn | 1198-743X | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/6027 | |
dc.identifier.eissn | 1469-0691 | |
dc.identifier.eissn | 1469-0691 | |
dc.identifier.doi | 10.1016/j.cmi.2023.07.021 | |
dc.identifier.doi | 10.1016/j.cmi.2023.07.021 | |
dc.description.abstract | OBJECTIVES: To determine whether early switch to oral antibiotic treatment in adults with neutropenic sepsis at low risk of complications is non-inferior to switching later. METHODS: This non-inferiority, parallel-group, randomized, open-label clinical trial enrolled UK adults hospitalized with neutropenic sepsis. Participants were randomly assigned to either switch to oral ciprofloxacin plus co-amoxiclav within 12-24 hours or to continue intravenous treatment for at least 48 hours. The primary outcome was a composite measure of treatment failure, 14 days after randomization. The non-inferiority margin was 15%. RESULTS: There were 129 participants from 16 centres and 125 were assessed for the primary outcome. Of these, 113 patients completed protocolized treatment and comprised the per-protocol population. In total, 9 (14.1%) of 64 patients in the standard care arm met the primary end point, compared with 15 (24.6%) of 61 in the early switch arm, giving a risk difference of 10.5% (1-sided 95% CI, -∞% to 22%; p 0.14). In the per-protocol population, 8 (13.3%) of the 60 patients in the standard care arm met the primary end point, compared with 9 (17%) of 53 in the intervention arm giving a risk difference of 3.7% (one-sided 95% CI, -∞% to 14.8%; p 0.59). Duration of hospital stay was shorter in the intervention arm (median 2 [inter-quartile range (IQR) 2-3] vs. 3 days [IQR 2-4]; p 0.002). DISCUSSION: Although non-inferiority of early oral switch was found in the per-protocol population, the intervention was not non-inferior in the intent-to-treat population. | |
dc.format | Print-Electronic | |
dc.format.extent | S1198-743X(23)00349-X - | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER SCI LTD | |
dc.relation.ispartof | Clinical Microbiology and Infection | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Antibiotic | |
dc.subject | Febrile neutropenia | |
dc.subject | Neutropenic sepsis | |
dc.subject | Oral | |
dc.subject | Randomized controlled trial | |
dc.subject | Treatment | |
dc.title | Early switch to oral antibiotic therapy in patients with low-risk neutropenic sepsis (EASI-SWITCH): a randomized non-inferiority trial. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2023-07-22 | |
dc.date.updated | 2023-10-20T13:25:20Z | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1016/j.cmi.2023.07.021 | |
rioxxterms.licenseref.startdate | 2023-07-28 | |
rioxxterms.type | Journal Article/Review | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/37517522 | |
pubs.organisational-group | ICR | |
pubs.organisational-group | ICR/Primary Group | |
pubs.organisational-group | ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.publication-status | Published online | |
pubs.publisher-url | http://dx.doi.org/10.1016/j.cmi.2023.07.021 | |
dc.contributor.icrauthor | Chau, Ian | |
icr.provenance | Deposited by Mr Arek Surman on 2023-10-20. Deposit type is initial. No. of files: 1. Files: 1-s2.0-S1198743X2300349X-main.pdf | |