Antimicrobials in cancer-unrelated neutropenia

Madeleine Verhovsek, MD, is an associate professor in the Department of Pathology and Molecular Medicine at McMaster University.

What are the indications for antimicrobial prophylaxis in neutropenia unrelated to cancer? Which drugs should be used?

Chronic neutropenia unrelated to cancer, unrelated to any therapy that the patient may be on—really, how to prevent that person from becoming sick depends a lot on why they’re neutropenic, to begin with. So, I would say that the approach to antimicrobial prophylaxis is usually going to be individualized and there aren’t any clear guidelines that somebody needs to be on antimicrobial prophylaxis on a continuous basis.

That being said, if a patient has a past history of infections or if they have severe neutropenia, having prophylaxis in specific situations, for example, if they’re having dental work, or also having prescriptions in case they’re traveling to places where they may end up contracting, for example, diarrheal illnesses, is a good idea.