Hashemi, A., Bahrololoumi, Z., Khaksar, Y., Saffarzadeh, N., Neamatzade, H., & Foroughi, E. (2015). Mouth-rinses for the prevention of chemotherapy induced oral mucositis in children: A systematic review. Iranian Journal of Pediatric Hematology and Oncology, 5, 106–112.

Purpose

STUDY PURPOSE: To evaluate studies on basic oral care interventions to update evidence-based practice guidelines for preventing oral mucositis in patients with cancer receiving chemotherapy
 
TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: PubMed and Google Scholar
 
KEYWORDS: Cancer, chemotherapy, children, mouthwash, and mucositis
 
INCLUSION CRITERIA: All papers were published between 2000 and December 2014 and used the terms mucositis, chemotherapy, mouth rinses, oral care, oral care protocol, dental care, dental cleaning, oral decontamination, and oral hygiene. Both research and clinical work were included.
 
EXCLUSION CRITERIA: Review articles, clinical case reports, literature reviews, and other nonresearch articles were excluded. Articles not written in English also were excluded. 

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 151
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: No evaluation method was identified.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 30
  • TOTAL PATIENTS INCLUDED IN REVIEW = Not reported
  • KEY SAMPLE CHARACTERISTICS: Chlorhexidine, benzydamine, sodium bicarbonate, granulocyte macrophage colony-stimulating factor, iseganan, sucralfate, and normal saline were reviewed. No sample characteristics were reported.

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment
 
APPLICATIONS: Pediatrics and palliative care

Results

None of the mouth rinses were definitely effective in preventing chemotherapy-induced oral mucositis in children. Normal saline had a preventive effect in patients receiving chemotherapy, radiotherapy, and hematopoietic stem cell transplantation, but other studies have shown less efficacy than chlorhexidine or honey with saline. Benzydamine was less effective than chlorhexidine.

Conclusions

There was limited evidence for agents to prevent or manage oral mucositis in children.

Limitations

  • Few studies for any single agent used
  • Few data bases used  
  • Limited sample information provided  
  • No quality of research evaluation

Nursing Implications

Mouth rinses are an important component to oral care in the prevention of mucositis in pediatric patients receiving chemotherapy. Nurses need to continue research to develop evidence-based practice guidelines for this debilitating side effect of chemotherapy.

Legacy ID

5620