title: Antimicrobial therapy to prevent or treat oral mucositis.
abstract: Oral mucositis represents a significant source of morbidity after chemotherapy and radiation therapy. Since infection may have an important role in the pathophysiology of oral mucositis, several antimicrobial agents have been investigated for their efficacy in preventing and treating this disease. We sought to establish the weight of evidence for antimicrobial treatment and identified 31 prospectively designed clinical trials of which 13 reported some benefit and 15 did not. No clear pattern was identified regarding patient type, cancer treatment, or type of antimicrobial agent used, and inconsistent assessment of oral mucositis made comparison of outcomes difficult. Newer drugs, such as the topical antimicrobial peptide iseganan HCl initially showed promise in reducing mucositis and the related oral pain but the results of a phase 3 trial were disappointing and the line of enquiry was abandoned altogether. Hence, there is a need to better understand the role of the microflora in the cause of oral mucositis if an antimicrobial agent for prevention and treatment of this disease is to be developed.
authors.affiliation: Supportive Care Studies, Department of Haematology, University Medical Centre, St Radboud, Nijmegen, Netherlands. p.donnelly@usa.net
authors.forename: J Peter
authors.initials: JP
authors.lastname: Donnelly
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Bellm
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Sonis
authors.forename: R Paul
authors.initials: RP
authors.lastname: Symonds
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D009061:Mouth Mucosa; D013280:Stomatitis / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control; D017211:Treatment Failure
chemical_list: D000890:Anti-Infective Agents