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Antimicrobial prophylaxis does not prevent infection in patients with head and neck cancer

20 May 2020

The incidence of infection is similar between head and neck cancer patients who received antimicrobial prophylaxis and those who did not, results of a recent study have shown. In addition, no difference is observed in the incidence of hospitalization, but the length of hospital stay is longer in the prescribed prophylactic group.

A retrospective review identified patients receiving chemoradiation for head and neck cancer at three outpatient oncology clinics between 2013 and 2016. Patients were categorized into two based on administration or omission of prophylactic antimicrobials. Incidence of infection was the primary outcome, while hospitalization and length of hospital stay were secondary ones.

Of the 77 patients included in the analysis, 41 (53 percent) were prescribed antimicrobial prophylaxis and 36 (47 percent) were not. Thirty-four patients in the prophylaxis group and 31 in the no prophylaxis group acquired an infection (82.9 percent vs 86.1 percent; p=0.945).

In terms of the secondary outcomes, 20 patients in the no prophylaxis group and 16 in the prophylaxis group were admitted to the hospital (p=0.222). Of note, the average length of hospital stay was significantly longer among patients prescribed antimicrobial prophylaxis than those who were not (10.6 vs 6 days; p=0.007).

“National guidelines do not recommend the routine use of antimicrobial prophylaxis in patients with solid tumours, yet prophylactic agents are still sometimes prescribed for head and neck cancer patients,” according to the authors.

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