Empirical antimicrobial intervention in patients with infectious complications after high-dose chemotherapy and autologous haematopoietic stem cell transplantation (ASCT) has not been studied extensively and has been selected in many of these patients according to recommendations for high-risk patients with haematological malignancies or patients under- SummaryWe report on 232 patients undergoing autologous haematopoietic stem cell transplantation (ASCT) entered into a multicentre, randomised trial comparing the efficacy and tolerability of meropenem (MPM) with that of piperacillin/tazobactam (P/T) as empirical antimicrobial first-line therapy for febrile neutropenia. In 27AE6% of patients in the MPM group and 22AE4% in the P/T group, therapy was initially supplemented with a glycopeptide for venous catheter infection or bacteraemia because of coagulase-negative staphylococci. Complete response rate after 72 h was 63AE8% in the MPM group and 49AE6% in the P/T group (P ¼ 0AE034). Overall complete response rate after treatment modification was 94AE0% in the MPM group and 93AE1% in the P/T group. Median time to defervescence was 2 d in the MPM group and 3 d in the P/T group. The most frequently isolated pathogens were Grampositive cocci. Treatment was well tolerated in both groups. One patient (0AE4%) died from infection. Empirical first-line therapy with MPM as well as with P/T is safe and effective in febrile episodes emerging after ASCT. Higher response rates to primary treatment can be achieved with MPM.

Integrating a wide range of biomedical data such as that rapidly emerging from the use of next-generation sequencing is expected to have a key role in identifying and qualifying new biomarkers to support precision medicine. Here, we highlight some of the challenges for biomedical data integration and approaches to address them.