Study design and population
This prospective study was conducted at Thammasat University Hospital (TUH), a tertiary care and teaching hospital, between August 1, 2019 and April 30, 2020. Two medical wards were pre-designated as the pharmacist-driven ASP group and two other similar medical wards were pre-designated as the control group. Febrile neutropenia in our study was defined as fever (single temperature equivalent to ≥38.3oC orally or equivalent to ≥38.0oC orally over a 1-hour period) with neutropenic condition (patient who had ≤500 neutrophils per microliter or ≤500 neutrophils per microliter and a predicted declined to ≤500 neutrophils per microliter over the next 48 hours). High risk of febrile neutropenia was identified by the Multinational Association for Supportive Care in Cancer (MASCC) risk index score less than 21.15Inclusion criteria included: Adult patients (i.e., age >18 years); patient diagnosed with febrile neutropenia; and patient received antibiotics for treatment of febrile neutropenia. Exclusion criteria included: receipt of antibiotics for febrile neutropenia <24 hours, pregnancy or lactation. This study was approved by the human research ethics committee, Thammasat University (no. 125/2019).