Role of the clinical pharmacist in managing rabies post-exposure prophylaxis in an elderly cancer patient: A case report from a tertiary care hospital

Abstract

Background

Immunocompromised patients undergoing cancer therapy are at increased risk for severe infections such as rabies. Coordinating rabies post-exposure prophylaxis (PEP) with ongoing treatment requires careful planning.

Case Presentation

A 73-year-old female with metastatic breast cancer, scheduled to begin second-line chemotherapy, sustained a WHO Category 3 cat scratch injury. A clinical pharmacist collaborated with oncology and infectious disease teams to promptly initiate rabies PEP. Rabies vaccine and monoclonal antibody were administered per national guidelines. The chemotherapy start date was deferred by five days based on pharmacist–infectious disease team consultation to ensure optimal vaccine response. The clinical pharmacist played a central role in timing decisions, vaccine administration, and patient education.

Conclusion

This case report underscores the complexities of managing infectious disease risks in immunocompromised oncology patients. The timely coordination of rabies post-exposure prophylaxis in a patient undergoing cancer treatment is a clinically relevant issue, especially given the potential for attenuated vaccine responses and treatment delays. The case provides a practical example of how clinical pharmacist-driven (interdisciplinary collaboration) interventions can enhance patient safety without compromising oncologic outcomes.