Comparative Effects of Chlorhexidine Gluconate and Povidone Iodine Mouthwashes to Chemotherapy-Induced Oral Mucositis in Children with Acute Lymphoblastic Leukemia (original) (raw)
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Oral health in children with leukemia
Indian Journal of Palliative Care, 2012
Leukemia is one of the most common malignancies affecting children in India. These children usually suffer from various oral complications, which may be due to the leukemia or due to the chemotherapeutic agents and/or radiotherapy. The complications may include some of the opportunistic infections like candidiasis, herpes simplex; hemorrhage, mucositis, taste alterations and increased incidence of dental caries etc. These complications can complications in these children and the methods of prevention and management.
Dental Care for Children with Leukemia: Major Updates
Leukemia is a haematological neoplasm that among 300 children and adolescents in Brazil. Its standard treatment consists of the use of antineoplastic based on chemotherapy or radiotherapy, these recommended therapies can provoke several side effects among them buccal alterations mainly due to the immunosupression picture. In view of the exposed this study has the objective to describe the main updates of the dental care to the child carrier of leukemia by reviewing the literature. Immunosuppression and the very fragility and stage of development of children with leukemia lead to greater vulnerability to all types of opportunistic infections and pathologies resulting from antineoplastic therapy. Currently, modern oncology requires the presence of the dentist in all phases of treatment and even before diagnosis in a sine qua non condition for management, maintenance of oral health and quality of life of the leukemic patient. The dentist besides being part of the cancer team is required both in the in-hospital environment and in daily clinical practice. Currently there is a wide range of resources and medicines to promote a satisfactory handling and quality of life for these patients.
Oncology Reviews, 2008
Oropharyngeal mucositis is the acute inflammatory and ulcerative reaction of the oral mucosa following radiation therapy to the head and neck region. It is such a common problem that nearly all head and neck cancer patients develop some degree of mucositis. This complication is usually transient in nature but it also represents an important clinical problem as it is a painful, debilitating, dose-dependent side effect for which there is no widely acceptable prophylaxis or effective treatment. As several authoritative groups have recently either undertaken sys-tematic reviews or issued guidelines on the management of mucositis, it is the aim of this review instead, to provide an overview of all the remedies and pharmaceutical agents available, as well as highlighting to researchers the gaps that need to be filled.
Aims: To better inform medical practitioners on the role of antiseptics in oropharyngeal health and disease, this article focuses on povidone-iodine (PVP-I), an established and widely-available antiseptic agent. Methodology: Review of the anti-infective profile, efficacy and safety of PVP-I in managing common upper respiratory tract infections such as the common cold, influenza and tonsillo-pharyngitis, as well as oral complications resulting from cancer treatment (oral mucositis), and dental conditions (periodontitis, caries). Results: Antiseptics with broad-spectrum anti-infective activity and low resistance potential offer an attractive option in both infection control and prevention. While there is some evidence of benefit of antiseptics in a variety of clinical settings that include dental and oral hygiene, dermatology, oncology, and pulmonology, there appears to be discordance between the evidence-base and practice. This is especially apparent in the management and prevention of oropharyngeal infections, for which the use of antiseptics varies considerably between clinical practices, and is in marked contrast to their dermal application, where they are extensively used as both a prophylaxis and a treatment of skin and wound infections, thus minimising the use of antibiotics. Conclusion: The link between oral and oropharyngeal health status and susceptibility to infection has long been recognised. The high rates of antibiotic misuse and subsequent development of bacterial resistance (e.g. increasing vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA)) in large parts of the world, especially across Asia Pacific, highlight the need for identifying alternative antimicrobials that would minimise the use of these medications. This, together with recent large-scale outbreaks of, for example, avian and swine influenza virus, further underline the importance of an increasing armamentarium for infection prevention and control.
Journal of Pediatric Nursing, 2019
This study was performed to determine the effect of oral care using chlorhexidine, vitamin E and honey on oral mucositis (OM) management in children treated in a pediatric intensive care unit (PICU). Design and methods: The study was a randomized controlled trial with a parallel design. The study sample was composed of 150 children who were treated in the PICU of a university hospital in Turkey. Children enrolled in the study were randomly divided into six groups based on the oral care solutions used (n = 25 in each group). The Demographic Information Form and the World Health Organization Oral Mucositis Index were used for data collection. Results: The mucositis indices of the children presenting with and without OM upon admission to the PICU were compared on days 1, 3, 6, 9, 12, 15, 18 and 21 and the study found that the mucositis index values of the children treated with vitamin E were significantly lower than in the other groups (p b 0.05 for each), while those of the children given chlorhexidine were significantly higher than in the other groups (p b 0.05 for each). Conclusions: At the end of the study, vitamin E was determined to be the most effective agent in OM management, followed by honey as the second most effective agent. Chlorhexidine was found to be less effective in OM management compared to the other two agents. Based on this, vitamin E is recommended for use in oral mucositispreventive and therapeutic oral care practices. Practice implications: The results of the present study conducted with PICU patients will be useful in the administration of oral care. These findings are also important for nurses who have the responsibility of oral mucositis management.
Current Oncology
Oral mucositis is a common and most debilitating complication associated with cancer therapy. Despite the significant clinical and economic impact of this condition, there is little to offer to patients with oral mucositis, and the medications used in its management are generally only palliative. Given that mucositis is ultimately a predictable and, therefore, potentially preventable condition, in this study we appraised the scientific literature to evaluate effective methods of prevention that have been tested in randomised controlled trials (RCTs). Published high-level evidence shows that multiple preventative methods are potentially effective in the prevention of oral mucositis induced by radiotherapy, chemotherapy, or both. Anti-inflammatory medications (including benzydamine), growth factors and cytokines (including palifermin), cryotherapy, laser-and-light therapy, herbal medicines and supplements, and mucoprotective agents (including oral pilocarpine) showed some degree of ef...
In-vitro comparative study to evaluate the efficacy of antimicrobial activity of Thymol(A), Chlorhexidine(B), Chlorhexidine plus triclosan (C), Cetylpyridinium chloride (D), Belleric myrobalan (E), Povidone iodine (F) mouthwashes against Staphylococcus aureus and Streptococcus mutans with distilled water as a control group was undertaken. The mouthwashes were tested at four different concentrations 1:4(25%), 1:1(50%), 3:4(75%) and full strength (100%). The antimicrobial activity was determined by using agar well diffusion method. The plates were allowed to incubated at 37oc for 24hr, 48hr and 72hr. Chlorhexidine plus triclosan emerged as the most effective mouthwash against Staphylococcus aureus (30mm to 35.33mm) and Streptococcus mutans (19mm to 27.5mm)] followed by Cetylpyridinium chloride, Chlorhexidine, Thymol, Belleric myrobalan. Povidone iodine and distilled water had no antimicrobial activity. It was concluded that the Chlorhexidine plus triclosan shows excellent antimicrobial activity but povidine iodine has no antimicrobial activity.
Use of Curcumin Mouthrinse in Radio-Chemotherapy Induced Oral Mucositis Patients: A Pilot Study
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2015
Introduction: Oral Mucositis is a complex and distinct pathobiologic entity resulting in injuries in mucosa that is a common complication in cancer patients undergoing chemotherapy (CT) and radiation therapy (RT). Phytochemicals, such as Curcumin, turmeric extract, has attracted great attention for its therapeutic benefits in clinical oncology due to its chemopreventive, antitumoral, chemosensibilizing and radiosensibilizing activities against various types of cancers and the complications associated with their management. Aim: To evaluate the efficacy and safety of curcumin mouthwash in the management of Oral Mucositis in cancer patients undergoing radio-chemotherapy. Materials and Methods: The research group consisted of 20 adult cancer patients undergoing radio-chemotherapy at the Regional Oncology Centre, who were evaluated for signs and symptoms of oral mucositis and then randomly divided into two groups. Standard preventive oral care i.e. chlorhexidine mouthwash 0.2% was given to one group while the other group was provided with freshly prepared curcumin mouthwash; each to be used thrice daily. Oral mucositis was assessed at days 0, 10 and 20. The World Health Organization (WHO) scale, the Oral Mucositis Assessment Scale (OMAS), and a Numerical Rating Scale (NRS; patient reporting scale of 0-10) were used. Adverse events were tracked. Statistical Analysis: Descriptive statistics, Independent sample t-test and repeated measure ANOVA test were performed. Results: Statistically significant difference was found in the NRS (p=0.000), Erythema (p=0.050), ulceration (p=0.000) and WHO scores (p=0.003) between the two groups. Conclusion: Curcumin was found to be better than chlorhexidine mouth wash in terms of rapid wound healing and better patient compliance in management of radio-chemotherapy induced oral mucositis. No oral or systemic complications were reported.