Abstract
Antimicrobial solutions are widely used in the nursing care of chemotherapy induced oral mucositis (OM). There is little evidence, however, supporting their use for reducing mucosal damage. In our study, 132 patients were randomized to use normal saline (n=65) or povidone-iodine diluted 1:100 (n=67) mouthwashes for OM prophylaxis and treatment after high-dose chemotherapy comprising BEAM or HD-L-PAM followed by autologous peripheral stem cell transplantation. The study groups were well balanced in respect of age, sex, chemotherapy and the number of CD34+ cells in the graft. No significant difference was found between the groups in respect of OM characteristics, fever of unknown origin (FUO) and other infections. The antimicrobial solution was less tolerable for patients. OM occurred significantly more often in females than in males (86% vs 60%, P=0.0016) and was worse and of longer duration. The mechanical effect of mouthwashes might have a certain importance in FUO prevention. When indicating oral rinses, the patient’s individual preference and tolerance of solutions offered should be considered.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sonis S, Oster G, Fuchs H, et al (2001) Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation. J Clin Oncol 19:2201–2205
Sezer O, Eucker J, Metzner B, et al (2000) Mucositis is associated with increased rate of documented infections and treatment related mortality after high-dose therapy with autologous peripheral stem-cell transplantation. Proc ASCO (abstract 216.)
Donnelly P, Bellm L, Epstein J, Sonis S, Symonds P (2003) Antimicrobial therapy to prevent or treat oral mucositis. Lancet Infect Dis 7:405–412
Ferreti GA, Raybould TP, Brown AT, et al (1990) Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomised double-blind trial. Oral Surg Oral Med Oral Pathol 69:331–338
Weisdorf DJ, Bostrom B, Raether D, et al (1989) Oropharyngeal mucositis complicating bone marrow transplantation: prognostic factors and the effect of chlorhexidine mouth rinse. Bone Marrow Transplant 4:89–95
Dodd MJ, Larson PJ, Dibble SL, et al (1996) Randomized clinical trial of chlorhexidine versus placebo for prevention of oral mucositis in patients receiving chemotherapy. Oncol Nurs Forum 23:921–927
Samaranayake LP, Robertson AG, MacFarlane TW, et al (1988) The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation. Clin Radiol 39:291–294
Lever SA, Dupuis LL, Chan HS (1987) Comparative evaluation of benzydamine oral rinse in children with antineoplastic-induced stomatitis. Drug Intel Clin Pharm 21:359–361
Prada A, Chisea E (1987) Effects of benzydamine on the oral mucositis during antineoplastic radiotherapy and/or intra-arterial chemotherapy. Int J Tissue React 9:115–119
Rahn R, Adamietz IA, Boettcher HD, Schaefer V, Reimer K, Fleischer W (1997) Povidone-iodine to prevent mucositis in patients during antineoplastic radiochemotherapy. Dermatology 195 [Suppl 2]:57–61
Allison RR, Vongtama V, Vaughan J, Shin KH (1995) Symptomatic acute mucositis can be minimized or prophylaxed by the combination of sucralfate and fluconazole. Cancer Invest 13:16–22
Okuno SH, Foote RL, Loprinzi CL, et al (1997) A randomized trial of nonabsorbable antibiotic lozenge given to alleviate radiation-induced mucositis. Cancer 79:2193–2199
Wijers OB, Levendag PC, Harms ER, et al (2001) Mucositis reduction by selective elimination of oral flora in irradiated cancers of the head and neck: a placebo-controlled double-blind randomized study. Int J Radiat Oncol Biol Phys 50:343–352
Karthaus M, Rosental C, Ganser A (1999) Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis—are there new strategies? Bone Marrow Transplant 24:1095–1108
Sonis S, Elting L, Keefe D, et al (2004) Perspectives on cancer therapy-induced mucosal injury. Cancer 100 [9 Suppl]:1995–2025
Robien K, Schubert M, Bruemmer B, et al (2004) Predictors of oral mucositis in patients receiving hematopoietic cell transplant for chronic myelogenous leukemia. J Clin Oncol 22:1268–1275
Acknowledgements
We acknowledge the assistance of K. Steinerova MD, I. Chvojková, V. Kaslová (Plzeň), J. Vítková (Olomouc), J. Maslová (Hradec Králové), P. Horvathová, V. Jarolíková, R. Micheličová (Bratislava), M. Visokaiová (Košice), A. Kalocayová, E. Karliková, S. Kerestenyová, S. Gyurkyová, and S. Staštianová (Bánská Bystrica).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vokurka, S., Bystřická, E., Koza, V. et al. The comparative effects of povidone-iodine and normal saline mouthwashes on oral mucositis in patients after high-dose chemotherapy and APBSCT—results of a randomized multicentre study. Support Care Cancer 13, 554–558 (2005). https://doi.org/10.1007/s00520-005-0792-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-005-0792-9