Prophylactic Antibiotics and Treatment for Head and Neck Cancer
Posted: Monday, May 6, 2019
Despite the fact that the use of prophylactic antibiotics did not improve the incidence of pneumonia in patients with locally advanced head and neck cancer, it was cost-effective in reducing hospitalization rates and fever episodes, according to a study published in the European Journal of Cancer. Carla M. van Herpen, MD, PhD, of Radboud University Medical Center, Nijmegen, The Netherlands, and colleagues suggested that adding prophylactic antibiotics during chemotherapy may be considered for this patient population.
“A significant difference in costs was found, with an average reduction of €1,425 per patient in favor of the prophylaxis group,” the authors concluded.
A total of 106 patients initially were included in the study, representing 6 centers. The researchers randomly assigned 95 patients with locally advanced head and neck cancer to receive prophylactic amoxicillin/clavulanic acid (n = 47) or standard care without prophylaxis (n = 48) during chemotherapy treatment. In this multicenter trial, the antibiotic was given from day 29 after the start of treatment until 14 days after completion of chemoradiotherapy or standard care without prophylaxis.
Although both groups experienced similar rates of pneumonia, the hospitalization rate was significantly higher among patients who received the standard of care. Pneumonia was observed in 22 patients (45.8%) in the standard group and 22 patients (46.8%) in the prophylaxis group (P = .54). Overall, 19 patients (38.6%) in the standard-of-care group versus 9 patients (19.1%) in the prophylaxis group were hospitalized (P = .03). In addition, fewer patients treated with prophylactic antibiotics experienced fevers. Of those treated with the standard of care, 29.2% had episodes of fever compared with 10.2% of patients in the prophylaxis group (P = .028).
Disclosure: The study authors’ disclosure information may be found at ejcancer.com.