title: The effect of polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair) on oral microbial colonization and pain control compared with other rinsing solutions in patients with oral mucositis after allogeneic stem cells transplantation.
abstract: BACKGROUND
  Gelclair is an oral lubricating gel used in the management of oral mucositis (OM). We evaluated its efficacy, tolerance and impact on oral cavity microbial colonization in patients with OM after allogeneic hematopoietic stem cells transplantation.
  
  
  METHODS
  Gelclair was administered in a group of 22 patients with active OM. A control group of 15 patients used other rinsing solutions (chlorhexidine, benzydamine, salvia). Tests with oral cavity swabs for microbiology analysis were performed once a week.
  
  
  RESULTS
  The characteristics of OM in both groups were comparable, and rinsing solutions had satisfactory tolerability. There was no difference in the median improvement of oral intake and OM-related pain relief, which was assessed mostly as "slight effect". In the Gelclair group, the effect duration was longer (median 3 [0-5] vs. 1 [0-3] hours, p = 0.001). There was significant increase of Enterococcus faecalis and Candida sp. colonization of the oral cavity over the course of the hospitalization and significantly reduced incidence of such colonization in patients with OM in the Gelclair group: 1/22 (5%) vs. 6/15 (40%), p = 0.01. In vitro tests showed inhibited growth of Enterococcus faecalis and Candida sp. colonies within the area of the Gelclair application.
  
  
  CONCLUSIONS
  Gelclair may be individually helpful in the management of OM and pain in patients after allogeneic stem cells transplantation. Its use did not lead to worsened oral bacterial and yeast colonization and probably even helped to protect mucosa from Enterococcus and Candida sp. Further studies based on larger cohorts are needed.
authors.affiliation: Department of Haemato-Oncology, University Hospital in Pilsen, Pilsen, Czech Republic. vokurka@fnplzen.cz
authors.forename: Samuel
authors.initials: S
authors.lastname: Vokurka
authors.forename: Jana
authors.initials: J
authors.lastname: Skardova
authors.forename: Renata
authors.initials: R
authors.lastname: Hruskova
authors.forename: Klara
authors.initials: K
authors.lastname: Kabatova-Maxova
authors.forename: Tomas
authors.initials: T
authors.lastname: Svoboda
authors.forename: Eva
authors.initials: E
authors.lastname: Bystricka
authors.forename: Katerina
authors.initials: K
authors.lastname: Steinerova
authors.forename: Vladimir
authors.initials: V
authors.lastname: Koza
mesh_terms: D001591:Benzydamine; D002175:Candida / Q000187:drug effects*; D002710:Chlorhexidine; D004338:Drug Combinations; D013293:Enterococcus faecalis / Q000187:drug effects*; D005157:Facial Pain / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology* / Q000627:therapeutic use; D011205:Povidone / Q000494:pharmacology* / Q000627:therapeutic use; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D013280:Stomatitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology*; D013997:Time Factors; D014184:Transplantation, Homologous / Q000009:adverse effects*
chemical_list: D004338:Drug Combinations; C439265:Gelclair; D001591:Benzydamine; D006820:Hyaluronic Acid; D011205:Povidone; D002710:Chlorhexidine