Hostname: page-component-7b7567c8c-2rsb6 Total loading time: 0 Render date: 2026-11-12T19:14:00.717Z Has data issue: false hasContentIssue false
  • English
  • Français

Improving Empiric Antibiotic Selection for Patients with Cancer Hospitalized with Infection: Secondary Analysis of the INSPIRE Trials

Published online by Cambridge University Press:  23 June 2026

Shruti Gohil,
Taliser Avery,
Ken Kleinman,
Ed Septimus,
Amarah Mauricio,
Kenneth Sands,
Neha Varma,
Selsebil Sljivo,
Kaleb Roemer and
William Cooper
...Show all authors
Shruti Gohil
Affiliation:
University of California, Irvine
Ken Kleinman
Affiliation:
University of Massachusetts, Amherst
Ed Septimus
Affiliation:
Harvard Medical School and Harvard Pilgrim Health Care Institute
Amarah Mauricio
Affiliation:
Division of Infectious Diseases, University of California, Irvine School of Medicine, Irvine, California
Kenneth Sands
Affiliation:
Hospital Corporation of America
Neha Varma
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Kaleb Roemer
Affiliation:
HCA Healthcare
Russell Poland
Affiliation:
HCA Healthcare
Robert Weinstein
Affiliation:
Rush University Medical Center
Samir Fakhry
Affiliation:
HCA Healthcare
Jefrey Guy
Affiliation:
Frist College of Medicine, Belmont University
Julia Moody
Affiliation:
HCA Healthcare
Micaela Coady
Affiliation:
Harvard Pilgrim Health Care Institute
Kimberly Smith-Sells
Affiliation:
HCA Healthcare
David Kubiak
Affiliation:
Brigham and Women’s Hospital
Richard Platt
Affiliation:
HMS/HPHC
Susan Huang
Affiliation:
University of California Irvine School of Medicine
Meghan Baker
Affiliation:
MGB, DFCI

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.

Background: Empiric extended-spectrum antibiotics are routinely given to patients with cancer despite low risk of infection with multidrug-resistant organisms (MDROs). This secondary analysis of the four INSPIRE (INtelligent Stewardship Prompts to Improve Real-time Empiric Antibiotic Selection) trials evaluated how computerized physician order entry (CPOE) prompts providing patient- and pathogen-specific MDRO risk estimates affected empiric extended-spectrum antibiotic use in patients with cancer. Methods: We identified non-critically ill hospitalized adults (> Results: Including all trials, 36,861 (18,272 baseline; 18,589 intervention) patients had cancer. Mean age was 69.0 (13.6); 48.0% (17,675) were male. Extended-spectrum antibiotic days-of-therapy decreased by 27% (95% CI:20-34%, PPPP Conclusions and Relevance: An antibiotic stewardship bundle that included CPOE prompts recommending standard-spectrum antibiotics for patients at low risk for antimicrobial-resistant infections reduced extended-spectrum antibiotic use in non-critically ill patients with cancer who were hospitalized with community-acquired pneumonia, UTI, abdominal infection, or SST, without observed differences in safety outcomes.

A table comparing primary and secondary outcomes for patients with cancer within the INSPIRE trials.

Information

Type
Antibiotic Stewardship
Information
Antimicrobial Stewardship & Healthcare Epidemiology , Volume 6 , Issue S1: SHEA Spring 2026 Abstracts , August 2026, pp. s1
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Footnotes

‡

The abstract titles in this supplement have been corrected since original publication. A notice detailing the changes has been published at https://doi.org/10.1017/ash.2026.10802.