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.
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.
Vokurka
Samuel
S
Department of Haemato-Oncology, University Hospital, Alej Svobody 80, Pilsen 304 60, Czech Republic. vokurka@fnplzen.cz
Bystrická
Eva
E
Koza
Vladimír
V
Scudlová
Jana
J
Pavlicová
Vladislava
V
Valentová
Dana
D
Bocková
Jana
J
Misaniová
Lubica
L
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
D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D003561:Cytarabine; D012965:Sodium Chloride; D005047:Etoposide; D011206:Povidone-Iodine; D008558:Melphalan; D002330:Carmustine