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Recruiting NCT07372131

NCT07372131 Antibiotic Duration and Outcomes in High-Risk Febrile Neutropenia Patients

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Clinical Trial Summary
NCT ID NCT07372131
Status Recruiting
Phase
Sponsor Humanitas University
Condition Bloodstream Infection
Study Type INTERVENTIONAL
Enrollment 172 participants
Start Date 2025-05-10
Primary Completion 2026-02-28

Eligibility & Interventions

Sex All sexes
Min Age 18 Years
Max Age N/A
Study Type INTERVENTIONAL
Interventions
Clinical Stability-Driven Antibiotic Discontinuation StrategyStandard of Care Antibiotic Duration

Eligibility Fast-Check

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What to Expect as a Participant

You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.

This trial targets 172 participants in total. It began in 2025-05-10 with a primary completion date of 2026-02-28.

⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.

Brief Summary

The goal of this clinical trial is to learn if a personalized duration of antibiotic therapy, based on clinical stability, is as effective as a standard duration of at least 10 days in hospitalized patients with hematologic malignancies (such as leukemia or lymphoma) who develop febrile neutropenia and Gram-negative bacteraemia. The main questions it aims to answer are: * Can a personalized antibiotic duration increase the number of days free from anti-Gram-negative therapy within 28 days without compromising patient safety? * How does the duration of antibiotic therapy (short vs. prolonged) affect the rate and modality of gut microbiota reconstitution? Researchers will compare: * Group A (Personalized Duration): Antibiotics are stopped after the patient maintains clinical stability (no fever and stable vital signs) for 72 consecutive hours. * Group B (Standard of Care): Antibiotics are continued for a standard duration, typically at least 10 days, based on current clinical surveys and physician decision. Participants will: * Be randomized to receive either the personalized or the standard duration of antibiotic therapy once a Gram-negative infection is confirmed in the blood. * Be monitored for 28 days to assess for new fever episodes, recurrence of infection, and overall survival. * If participating in the microbiological sub-study, provide biological samples (blood, feces, and rectal swabs) at specific time points (at the onset of fever, at the end of treatment, and at day 28). * Undergo specialized laboratory testing (Whole Metagenomic Sequencing) on the collected samples to evaluate the evolution of their intestinal and blood microbiota and the presence of antibiotic-resistant genes.

Eligibility Criteria

Inclusion Criteria: * Diagnosed with a hematologic malignancy that is candidate for treatment with chemotherapy or bone marrow transplantation or chimeric antigen receptor T cell therapy (CAR-T) * Diagnosis of febrile neutropenia defined according to the guidelines of the Infectious Disease Society of America, IDSA; ref: Freifeld, A.G., et al., Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis, 2011. 52(4): p. e56-93.) as: Fever: single record of oral temperature \>=38.3°C or a temperature \>=38.0°C sustained over a period of one hour; Neutropenia: absolute neutrophil count \< 1000 cells/microL; Expected duration of neutropenia \>= 7 days * Diagnosis of bacteraemia defined by positive blood cultures (at least 1 vial positive for a non-contaminating microorganism) * Isolation of Gram-Negative species Exclusion Criteria: * Contextual diagnosis of pneumonia * Contextual diagnosis of intra-abdominal infection, in particular: neutropenic enterocolitis/typhlitis or biliary tract infection * Persistently positive blood cultures at randomization * Any condition that endangers the safety of the patient based on the judgment of the treating physician

Contact & Investigator

Central Contact

Valeria Cento, MD, PhD

✉ valeria.cento@hunimed.eu

📞 0282243166

Principal Investigator

Valeria Cento, MD, PhD

PRINCIPAL INVESTIGATOR

Humanitas University

Frequently Asked Questions

Who can join the NCT07372131 clinical trial?

This trial is open to participants of all sexes, aged 18 Years or older, studying Bloodstream Infection. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.

Is NCT07372131 currently recruiting?

Yes, NCT07372131 is actively recruiting participants. Contact the research team at valeria.cento@hunimed.eu for enrollment information.

Where is the NCT07372131 trial being conducted?

This trial is being conducted at Rozzano, Italy.

Who is sponsoring the NCT07372131 clinical trial?

NCT07372131 is sponsored by Humanitas University. The principal investigator is Valeria Cento, MD, PhD at Humanitas University. The trial plans to enroll 172 participants.

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