Mutters, N.T., Neubert, T.R., Nieth, R., & Mutters, R. (2015). The role of Octenidol^®, Glandomed^® and chlorhexidine mouthwash in the prevention of mucositis and in the reduction of the oropharyngeal flora: A double-blind randomized controlled trial. GMS Hygiene and Infection Control, 10, Doc05. 

To assess the efficacy of Octenidol^®, Glandomed^®, and chlorhexidine mouthwash in the prevention of mucositis and the reduction of the oropharyngeal flora

An oral rinse of 100 ml with 50 cc of chlorhexidine or Octenidol was applied to buccal, pharyngeal, gingival, and tooth surfaces for 30 seconds four times per day in the strata 1 group. The strata 2 group used a Glandomed solution 100 ml rinse with 500 cc of Glandomed or Octenidol applied to pharyngeal, gingival, and tooth surfaces for 30 seconds four times a day. Oral swab samples were taken and incubated for 36–48 hours.

• N = 93  
• MEAN AGE RANGE = 41.4–65.2 years
• MALES: 70.7% (strata 1); 84% (strata 2), FEMALES: 31% (strata 1); 52.2% (strata 2)
• KEY DISEASE CHARACTERISTICS: Strata 1 included patients who were ventilated for ≥ 24 hours independently of a specific diagnosis. Patients randomized to strata 2 received myeloablative, allogeneic, or autologous hematopoietic stem cell transplantation after receiving high-dose chemotherapy.
• OTHER KEY SAMPLE CHARACTERISTICS: All patients were aged 18 years or greater and were admitted inpatients. 

• SITE: Single site    
• SETTING TYPE: Inpatient    
• LOCATION: University Hospital Marburg in Germany

• PHASE OF CARE: Multiple phases of care
• APPLICATIONS: Elder care and palliative care 

Prospective, double-blinded, randomized, controlled study dividing patients into two strata

• The Oral Mucositis Assessment Scale (OMAS) and World Health Organization (WHO) mucositis scoring systems were used to determine levels of mucositis.
• A statistic analysis was performed using the SPSS package.

Both strata showed low OMAS and WHO scores, which did not differ significantly between the groups. Overall oropharyngeal flora was significantly reduced in the Octenidol group compared to the chlorhexidine and Glandomed groups.

All solutions resulted in low grades of mucositis according to the OMAS and WHO scoring systems. Octenidol reduced oropharyngeal flora more than chlorhexidine and Glandomed.

• Small sample (< 100)
• Risk of bias (no control group)

In this study, Octenidol proved to be superior to chlorhexidine and Glandomed in reducing oropharyngeal flora. This could potentially reduce the occurrence of hospital-acquired infections and ventilator-associated pneumonia.