Introduction
Febrile neutropenia is a life-threatening complication of cancer therapy which can increase morbidity and mortality.1 Broad spectrum antimicrobial agent administration is an essential part of the treatment of febrile neutropenia to cover hospital-acquired pathogens. Pharmacokinetic alterations of several antibiotics (e.g., piperacillin/tazobactam) were found in febrile neutropenic patients.2-3 Prescribing antibiotics with common dosage regimens might be inadequate for these patients. Furthermore, incorrect antibiotic dosing was found as the most common non-compliant antibiotic prescription practice in febrile neutropenic patients.4 Antibiotic optimization would be a challenging method among febrile neutropenic patients. An antibiotic stewardship program (ASP) in immunocompromised patients is suggested by the Infectious Diseases Society of America (IDSA) 2010 guideline.5 Recent evidence supports that adherence to ASP is associated with a lower mortality rate.6Although several studies have shown the effectiveness of ASP implementation in febrile neutropenic patients, there is limited evidence of the effectiveness of ASP implementation led by a pharmacist.7-11 Pharmacist-driven ASP has been reported to increase antibiotic appropriateness in several studies.12-14 We believe this is the first study to demonstrate that pharmacist-driven ASP can be beneficial among febrile neutropenic patients. Our study compared antibiotic appropriateness between a pharmacist-driven ASP and a control group.