Use of mupirocin and chlorhexidine as preventive treatment for radiodermatitis in patients with head and neck tumors

Abstract

Introduction: 95% of patients undergoing radiotherapy for head and neck tumors develop acute radiodermatitis, forcing treatment to be temporarily suspended depending on the severity, compromising local control. Colonization with Staphylococcus aureus is a risk factor for developing this effect. Objetive: we will evaluate the efficacy of the decolonization protocol (intranasal mupirocin and topical chlorhexidine) in reducing the incidence and severity of radiodermatitis. Method: descriptive, observational, semi-longitudinal, multicenter follow-up study. The study will last 18 months. In this preliminary cut-off in 10/2025, we recruited 22 patients. They received radiotherapy in accordance with the protocol of applying mupirocin to the nasal nostrils twice a day and cleaning the treatment area with chlorhexidine spray once a day, from 3 days before until the end of radiotherapy. The irradiated area was photographed weekly until the end of radiotherapy, and the degree of radiodermatitis was determined according to the RTOG. Results: acute radiodermatitis occurred in 100% of patients. Grade 2 was the highest grade in seven cases, six as intense erythema and one with moist dermatitis in patches. The rest experienced Grade 1 radiodermatitis.Four patients were temporarily suspended due to mucositis, in one case associated with grade 2 radiodermatitis (wet desquamation in patches). Conclusion: the findings of this study suggest the clinical efficacy of the protocol as a prophylactic strategy for grade 2 or higher radiodermatitis, thus reducing treatment interruption due to skin toxicity and ensuring adherence to the planned treatment regimen.