SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Systematic review of prophylactic antibacterial agents for radiation-induced oral mucositis in head and neck cancer.
Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the use of treatments with antibacterial properties as prophylaxis prior to radiotherapy (RT), either alone or in combination with chemotherapy (CT), to prevent and reduce radiation-induced oral mucositis (RIOM) in patients with head and neck cancer (HNC). DATA SOURCES: A systematic search following PRISMA guidelines was conducted across PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant studies published in English through March 2025. REVIEW
methodsEligible studies assessed prophylactic antibacterial interventions aimed at preventing RIOM.
resultsFrom 86 retrieved citations, 9 articles met inclusion criteria. Antibacterial agents assessed included polymyxin, tobramycin, amphotericin (PTA), povidone iodine, SAMITAL, and Nigella sativa (NS). Evidence supporting povidone iodine, PTA, and SAMITAL was inconclusive or failed to demonstrate statistically significant reductions in RIOM severity. Several studies reported discordant findings, with statistically significant improvements in patient-reported symptoms or quality-of-life measures despite nonsignificant clinician-assessed scores. NS demonstrated potential benefits in reducing RIOM incidence and severity compared with standard of care and other antibacterial agents.
conclusionThe systematic review highlights limited and inconsistent evidence supporting antibacterial prophylaxis for preventing and reducing RIOM severity in patients with HNC undergoing RT. Discrepancies between patient-reported outcomes and clinical-assessed grading suggest some treatments may provide symptomatic benefit not captured by traditional scoring systems. NS mouthwashes showed preliminary promise; however, evidence remains insufficient to establish superiority, and safety and regulatory concerns are persistent, particularly in immunosuppressed patients. Given the role of bacterial colonization and microbial dysbiosis in RIOM pathogenesis, larger, well-designed clinical trials with rigorous safety evaluations are warranted to investigate bacterial-directed preventive therapies.
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