The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation

Samaranayake, LP; Robertson, Anne S.; MacFarlane, T. W.; Hunter, Ian; Macfarlane, Gary J.; Soutar, David S.; Ferguson, M.M.

doi:10.1016/s0009-9260(88)80538-5

Cited by 107 publications

(67 citation statements)

References 18 publications

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“…15 However, considering that the topical use of such proven antibacterial agents as chlorhexidine and hydrogen peroxide gave predominately negative results, this points to the limited value of the antimicrobial approach alone. [12][13][14] Moreover, the use of these agents may adversely affect the mucosa while curtailing microbial growth. With regard to the cytoprotective activity of amifostine, it has been shown to reduce mucositis and complications associated with high-dose chemotherapy in some studies.…”

Section: Discussionmentioning

confidence: 99%

“…Mixed results Ferretti et al (+) 11 Samaranayake et al 1988 (À) 12 Foote 1994 (À) 13 23 Crawford et al 24 …”

Section: Chlorhexidinementioning

confidence: 99%

“…A number of studies have attempted to evaluate different agents or strategies to prevent or treat mucositis associated with high-dose chemotherapy, with conflicting results (Table 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Prior studies on oral health-care management in oncology patients undergoing head and neck radiation, with or without chemotherapy, have suggested that a preventive regimen designed to address the reduced salivary flow and/or xerostomia was effective in reducing and controlling both the incidence and severity of mucositis. 9,28 The system used in these prior studies consisted of a high fluoride gel administered together with a neutral supersaturated Ca 2+ /PO 4 3À mouth rinse (Caphosol s ).…”

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confidence: 99%

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A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoietic stem cell transplantation

Papas

Clark

Martuscelli

et al. 2003

Bone Marrow Transplant

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Summary:Oral mucositis is a complication common to many cancer therapies and produces considerable pain and morbidity. The present study reports a double-blind, prospective, randomized clinical trial testing the efficacy of a calcium phosphate mouth rinse (Caphosol s ) with fluoride treatments vs a standard regimen of fluoride rinsing and placebo tray treatments in 95 patients undergoing hematopoietic stem cell transplantation (HSCT). The days and severity of mucositis were prospectively evaluated. There were statistically significant decreases in days of mucositis (3.72 vs 7.22 P ¼ 0.001), duration of pain (2.86 vs 7.67, P ¼ 0.0001), dose of morphine (34.54 mg vs 122.78 mg), days of morphine (1.26 vs 4.02, P ¼ 0.0001) and days to the onset of engraftment ANC (absolute neurotrophil count)4200 mm 3 (11.12 vs 12.56) in the Caphosol s and fluoride treatment group vs fluoriderinse group, respectively. Caphosol s , a neutral, supersaturated, Ca 2+ /PO 4 3À mouth rinse, used in combination with topical fluoride treatments, is superior to fluoride rinse alone in reducing the frequency, intensity and duration of oral mucositis in patients undergoing HSCT.

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Section: Discussionmentioning

confidence: 99%

“…Mixed results Ferretti et al (+) 11 Samaranayake et al 1988 (À) 12 Foote 1994 (À) 13 23 Crawford et al 24 …”

Section: Chlorhexidinementioning

confidence: 99%

mentioning

confidence: 99%

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A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoietic stem cell transplantation

Papas

Clark

Martuscelli

et al. 2003

Bone Marrow Transplant

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“…However, initial severe oral stinging decreases patient compliance and may require additional topical anaesthetics. 75 Therefore, the beneficial effect of benzydamine seems to be questionable.…”

Section: Mouthrinses With Anti-infective and Anesthetic Propertiesmentioning

confidence: 99%

Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis – are there new strategies?

Karthaus

Rosenthal

Ganser

1999

Bone Marrow Transplant

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Summary:Oral mucositis is a major dose-limiting toxic effect of intensive cancer chemotherapy. Oral complications may lead to dose reduction or delay in further cancer treatment. Mucositis can be caused directly by cytotoxic effects and indirectly by sustained neutropenia after cytostatic therapy. An impaired mucosal barrier predisposes to life-threatening septic complications during aplasia. The prevalence of an oral focus in febrile neutropenia has been reported in up to 30% of cases and also reduces quality of life. The basic strategies aim at pain relief and prevention of bacterial and fungal infectious complications. However, no effective causal prophylaxis or treatment of oral mucositis is widely accepted. The introduction of cytokines, eg granulocytemacrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) for oral mucositis may be particularly effective and offer a new and hopeful approach. At present, the optimal growth factor, best schedule, effective dosage and best mode of application is not known.

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“…Altogether, 92% of the patients using benzydamine complained of pain in the mouth when using the mouthwash, and 50% refused to continue to use benzydamine (Samaranayake et al, 1988). A controlled trial of this agent compared with a placebo (10% alcohol) claimed that radiation mucositis was reduced.…”

Section: Traditional Remediesmentioning

confidence: 99%

Treatment-induced mucositis: an old problem with new remedies

Symonds

1998

Br J Cancer

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Summary Mucositis may be a painful, debilitating, dose-limiting side-effect of both chemotherapy and radiotherapy for which there is no widely accepted prophylaxis or effective treatment. The basis of management is pain relief, prevention of dehydration and adequate nutrition. When tested vigorously, most antiseptic mouthwashes and anti-ulcer agents are ineffective. Simple mechanical cleansing by saline is the most effective traditional measure. A variety of new agents are effective. Granulocyte macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) act outwith the haemopoeitic system and can reduce mucositis, but the best schedule, dosage and method of administration is not known or which is the best growth factor to prevent this side-effect. A placebo-controlled randomized trial of antibiotic pastilles has shown a significant reduction in mucositis and weight loss during radiotherapy for head and neck cancer. Another method to reduce radiation effects in normal tissue is to stimulate cells to divide before radiotherapy by silver nitrate or interleukin 1. These methods may be particularly effective when given along with hyperfractionated radiation treatment such as CHART.

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The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation

Cited by 107 publications

References 18 publications

A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoietic stem cell transplantation

A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoietic stem cell transplantation

Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis – are there new strategies?

Treatment-induced mucositis: an old problem with new remedies

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