title: 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.
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.
authors.affiliation: Department of Haemato-Oncology, University Hospital, Alej Svobody 80, Pilsen 304 60, Czech Republic. vokurka@fnplzen.cz
authors.forename: Samuel
authors.initials: S
authors.lastname: Vokurka
authors.forename: Eva
authors.initials: E
authors.lastname: Bystrická
authors.forename: Vladimír
authors.initials: V
authors.lastname: Koza
authors.forename: Jana
authors.initials: J
authors.lastname: Scudlová
authors.forename: Vladislava
authors.initials: V
authors.lastname: Pavlicová
authors.forename: Dana
authors.initials: D
authors.lastname: Valentová
authors.forename: Jana
authors.initials: J
authors.lastname: Bocková
authors.forename: Lubica
authors.initials: L
authors.lastname: Misaniová
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009067:Mouthwashes; D036102:Peripheral Blood Stem Cell Transplantation; D011206:Povidone-Iodine / Q000008:administration & dosage / Q000627:therapeutic use*; D012737:Sex Factors; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use*; D013280:Stomatitis / Q000188:drug therapy*; D014182:Transplantation, Autologous
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D003561:Cytarabine; D012965:Sodium Chloride; D005047:Etoposide; D011206:Povidone-Iodine; D008558:Melphalan; D002330:Carmustine