Abstract
PurposeHead and neck cancers are multi-factorial diseases that can affect many sides of people's life and are due to a lot of risk factors. According to their characteristics, the treatment can be surgical, use of radiation or chemotherapy. The use of a surgical treatment can lead to surgical infections that are a main theme in medicine. At the University hospital of Naples “Federico II”, two antibiotics were employed to tackle the issue of the infections and they are compared in this paper to find which one implies the lowest length of hospital stay (LOS) and the reduction of infections.Design/methodology/approachThe Six Sigma methodology and its problem-solving strategy DMAIC (define, measure, analyse, improve, control), already employed in the healthcare sector, were used as a tool of a health technology assessment between two drugs. In this paper the DMAIC roadmap is used to compare the Ceftriaxone (administered to a group of 48 patients) and the association of Cefazolin plus Clindamycin (administered to a group of 45 patients).FindingsThe results show that the LOS of patients treated with Ceftriaxone is lower than those who were treated with the association of Cefazolin plus Clindamycin, the difference is about 41%. Moreover, a lower number of complications and infections was found in patients who received Ceftriaxone. Finally, a greater number of antibiotic shifts was needed by patients treated with Cefazolin plus Clindamycin.Research limitations/implicationsWhile the paper enhances clearly the advantages for patients' outcomes regarding the LOS and the number of complications, it did not analyse the costs of the two antibiotics.Practical implicationsEmploying the Ceftriaxone would allow the Department of Maxillofacial Surgery to obtain lower LOS and a limited number of complications/infections for recovered patients, consequently reducing the hospitalization costs.Originality/valueThere is a double value in this paper: first of all, the comparison between the two antibiotics gives an answer to one of the main issues in medicine that is the reduction of hospital-acquired infections; secondly, the Six Sigma through its DMAIC cycle can be employed also to compare two biomedical technologies as a tool of health technology assessment studies.
Highlights
Head and neck cancers are referred to those malignant tumoral pathologies that can occur in a district that comprehends the skull and the neck from the lower edge of the jaw until the upper edge of the clavicles
The results show that the length of hospital stay (LOS) of patients treated with Ceftriaxone is lower than those who were treated with the association of Cefazolin plus Clindamycin, the difference is about 41%
The Mann–Whitney test was, employed to compare, according to each category, the LOS of patients who were treated with Cefazolin/Clindamycin with the one of patients treated with Ceftriaxone
Summary
Head and neck cancers are referred to those malignant tumoral pathologies that can occur in a district that comprehends the skull and the neck from the lower edge of the jaw until the upper edge of the clavicles. Because of the involvement of the face and the neck, these kinds of cancers can affect several important biological functions such as breathing, talking and swallowing depending on the different anatomical parts where the primary tumor is located (Lester et al, 2012). The head and neck district is a very important anatomical region that allows many physiological functions. The aesthetic aspect is important when talking about head and neck cancers, due to the district where this kind of malignant tumor arises. Among head and neck cancers, oral squamous carcinoma is one of the most common cancers of the face and the most common of the mouth. It represents alone the 90% of the malignancies of the oral cavity [1]
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