Effectiveness Not Established

Garlic

for Prevention of Infection: General

Garlic is a plant species in the onion genus that has been used for culinary and medicinal purposes. Garlic extracts demonstrated broad-spectrum antimicrobial activity in vivo. Garlic extract has been examined for its effect in the prevention of infection among patients with cancer

Research Evidence Summaries

Gatt, M.E., Strahilevitz, J., Sharon, N., Lavie, D., Goldschmidt, N., Kalish, Y., . . . Paltiel, O.B. (2015). A randomized controlled study to determine the efficacy of garlic compounds in patients with hematological malignancies at risk for chemotherapy-related febrile neutropenia. Integrative Cancer Therapies. Advance online publication. 

Study Purpose

To evaluate the efficacy of garlic compounds to reduce the risk and severity of infections among patients with hematologic malignancies

Intervention Characteristics/Basic Study Process

Patients were stratified according to National Comprehensive Cancer Network criteria for febrile neutropenia (FN) to receive either garlic or a placebo. Patients began the intervention after the last day of their courses of chemotherapy and continued until the resolution of neutropenia. Garlic was given in two doses of 450 mg active compound per day.

Sample Characteristics

  • N = 95
  • MEAN AGE = 56 years (range = 20–82 years)
  • MALES: 64.2%, FEMALES: 35.8%
  • KEY DISEASE CHARACTERISTICS: Patients had acute myeloid leukemia, non-Hodgkin lymphoma, acute lymphoblastic leukemia, Hodgkin disease, and other types of hematologic malignancies; most patients had active disease at the time of the study and slightly less than half had previous FN in both study groups 
  • OTHER KEY SAMPLE CHARACTERISTICS: Greater than 60% of patients in both groups were receiving trimethoprim or sulfamethoxazole.

Setting

  • SITE: Single site  
  • SETTING TYPE: Multiple settings  
  • LOCATION: Israel

Phase of Care and Clinical Applications

  • PHASE OF CARE: Transition phase after active treatment

Study Design

Placebo-controlled, double blinded, randomized trial

Measurement Instruments/Methods

  • Complete blood counts
  • Primary outcomes were time to and onset of fever greater than 38°C   
  • Number of FN episodes

Results

The majority of patients in both groups developed neutropenia and febrile episodes at similar rates. The number of positive cultures was similar. More patients receiving garlic stopped before the end of the period of neutropenia (19.5% in the garlic group compared to 4% in the placebo group). In the very high-risk group, more patients receiving garlic developed fever. In the intermediate risk group, fewer patients receiving garlic developed fever. There were no adverse events associated with garlic use.

Conclusions

Garlic did not appear to provide any protective effect against the development of febrile episodes during neutropenia in these patients.

Limitations

  • Small sample (< 100)

 

Nursing Implications

Garlic extract appeared to be safe for patients with hematologic malignancies but did not show any efficacy for the prevention of fever or infection during neutropenic periods.

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