Vokurka, S., Bystricka, E., Koza, V., Scudlova, J., Pavlicova, V., Valentova, D., et al. (2005). The comparative effects of povidone-iodine and normal saline mouthwashes on oral mucositis in patients after high-dose chemotherapy and APBSCT: Results of a randomized multicentre study. Supportive Care in Cancer, 13(7), 554–558.

The goal of the study was to define the role of anti-microbial solutions.

Two groups of patients were compared: Normal saline mw povidone-iodine mw.
Group A used NS for oral rinsing and Group B use povidone-iodine diluted 1:100 water. The solutions were blinded to patients. Study nurse started first day and covered the whole inpatient stay. It was a 2 min gargle 4x/day IN the presence of OM the mouthwashes could be more frequent according to patients' wishes. Used soft toothbrush 4 x/day. If bleeding occurred would do only MW

Mouthwash was blinded.

The study was comprised of 132 patients. Patients were treated with hi-dose BEAM or HD-LPAM followed by APSCT.

Study group A had 65 pts or group B had 67 patients, NS or povidone iodine.
 

Multicenter

Jan 2002- June 2004

Prospective, randomized

• OM assessed daily
• WHO scale
• VAS for tolerability
• Temp, oral smears
• Blood cultures with fever
   

No significant difference with oral mucositis (p = 1.0) characteristics in both groups and fever of unknown origin (p = 1.0) and other infections (p = 0.34). Povidone-iodine was less tolerable.

No healing effect with betadine.

OM occurred more significantly in females than in males (p = .0016) and was worse and of longer duration.
 

Patients disliked the taste of povidone-iodine, less use of povidone-iodine.

Note appropriate dose of povidone-iodine.