The aim of this survey was to summarize the current antimicrobial practice in febrile neutropenia and the presence of key aspects of antimicrobial stewardship. A questionnaire was sent to 567 centers, and complete responses were obtained from 194 (34.2%). Fluoroquinolone and co-trimoxazole prophylaxis are used in 57.1% and 89.1%, respectively. In 66.4%, the first-line empirical therapy is piperacillin/tazobactam, whereas 10.9% use carbapenems. Empirical combination therapy is used in stable patients without history of resistant pathogens in 37.4%. De-escalation to monotherapy is performed within 3 days in 35.3% and after 10 days in 19.1%. Empirical addition of a glycopeptide is performed when fever persists more than 2–3 days in 60.8%. Empirical escalation to a broader spectrum agent is performed when fever persists more than 3–5 days in 71.4%. In case of positive blood cultures with a susceptible pathogen and uncomplicated presentation, 76.7% of centers de-escalate and 36.6% discontinue before neutrophil recovery. In fever of unknown origin with uncomplicated presentation, 54.1% of centers de-escalate and 49.5% discontinue before neutrophil recovery. Recommendations put forward in the ECIL guidelines are not widely implemented in clinical practice. Specific problems include overuse of carbapenems and combination therapy and unjustified addition of glycopeptides without further de-escalation or discontinuation.

本次调查的目的是总结目前在发热性中性粒细胞减少症中的抗菌实践以及抗菌药物管理的关键方面的存在。向 567 个中心发送了问卷，得到了 194 个（34.2%）的完整答复。氟喹诺酮和复方新诺明的预防使用率分别为 57.1% 和 89.1%。66.4% 的一线经验性治疗是哌拉西林/他唑巴坦，而 10.9% 使用碳青霉烯类药物。37.4% 的无耐药病原体病史的稳定患者使用经验性联合治疗。35.3% 的患者在 3 天内降级为单药治疗，19.1% 的患者在 10 天内降级为单药治疗。当发烧持续超过 2-3 天时，60.8% 的人根据经验添加糖肽。当发烧持续超过 3-5 天时，71.4% 的人会根据经验升级为更广谱的药物。在具有易感病原体和简单表现的阳性血培养的情况下，76.7% 的中心降级，36.6% 的中心在中性粒细胞恢复之前停止。不明原因发热，表现不复杂，54。1% 的中心降级，49.5% 的中心在中性粒细胞恢复前停止。ECIL 指南中提出的建议并未在临床实践中广泛实施。具体问题包括过度使用碳青霉烯类药物和联合治疗以及在没有进一步降级或停药的情况下不合理地添加糖肽。