The impact of antibiotic selection and interval time among advanced non‐small cell lung cancer patients receiving prior antibacterial treatment and first‐line chemotherapy

Background To determine whether antibiotic use before chemotherapy is associated with chemotherapy responses and patient outcomes among NSCLC patients and define the optimal interval between chemotherapy initiation and antibiotic treatment. Materials and methods One thousand four hundred and four advanced NSCLC patients receiving first‐line platinum‐based doublets therapy were retrospectively analyzed. Kaplan–Meier curve evaluated the impact of antibiotic use and type of antibiotics on the survival of patients. The factors affect the patient's prognosis were further confirmed by Cox regression. The optimal interval between antibiotic treatment and the initiation of chemotherapy was determined by the X‐tile program. Results NSCLC patients of 33.5% advanced underwent broad‐spectrum antibiotic treatment prior to chemotherapy. In the chemotherapy only (Chemo) and chemotherapy plus antiangiogenesis (Chemo‐angio) treatment groups, prior antibiotic treatment was associated with worse OS (Chemo: 13.8 vs. 17.6 months, p