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.