Chlorhexidine mouthwash as effective as ice at reducing oral mucositis
from chemotherapy
Chlorhexidine mouthwash is as effective in reducing oral mucositis as sucking crushed ice during bolus chemotherapy, according to a Danish study.
The study randomly assigned 225 patients being treated for gastrointestinal
cancers with bolus 5-fluorouracil (5-FU) and leucovorin over five days
to chlorhexidine 0.1 per cent mouthwash (15ml for one minute, three times
daily for three weeks) or normal saline with the same taste additive
as the mouthwash, or to crushed ice, kept in the mouth 10 minutes before
to 35 minutes after chemotherapy.
A questionnaire returned by 206 of the patients showed that mucositis
severe enough to reduce their ability to eat or to require artificial
nutrition affected 33 per cent of the placebo group, but only 13 per
cent of the patients using chlorhexidine, which was similar to the proportion
among those using crushed ice (11 per cent). The median duration of mouth
sores and ulcers was reduced from five days with placebo to three days
for the chlorhexidine group and one day for patients sucking ice.
Jens Sorensen, from the department of oncology, National University Hospital,
Copenhagen, Denmark, said that many patients are now treated with longer
duration infused chemotherapy regimens, making it impossible to keep
ice in the mouth throughout the entire treatment period. Oral mucositis
affects about 40 per cent of patients given bolus 5-FU chemotherapy,
he added.
Steve Williamson, lead pharmacist for Northern Cancer Network and Northumbria
Trust, said: “This research is helpful in expanding the evidence
base for current practice. Oral mucositis is a particular problem with
infused 5-FU and pharmacists are often called upon to advise on therapeutic
choices to manage this condition. Both ice and chorhexidine mouthwash
are commonly used. Pharmacists can be confident in recommending chorhexidine
mouthwash.” |
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