Prevention and Treatment of Chemotherapy-Induced Febrile Neutropenia in Adults

Febrile neutropenia (FN), a potential complication of myelosuppressive chemotherapies for various solid and hematologic malignancies, can contribute to subsequent dose reductions or treatment delays. For chemotherapy regimens that carry a >20% risk of FN, prophylactic use of a granulocyte colony-stimulating factor (G-CSF) may be indicated. Several FDA-approved biosimilars of short-acting and long-acting G-CSFs are available. Antimicrobial prophylaxis is used in neutropenic patients in an attempt to prevent FN, with each regimen tailored per patient and disease-specific characteristics. In patients who develop high-risk FN after chemotherapy, front-line antibiotic options should provide broad-spectrum coverage, including pseudomonal infection. Pharmacists in outpatient and inpatient settings have numerous drug-related intervention opportunities for the prevention and treatment of FN in adults.