Effectiveness Not Established

Corticosteroids, Topical

for Mucositis

Corticosteroids are a class of steroid hormones produced in the adrenal cortex. They are involved in a wide range of physiologic systems such as the stress and immune responses, the regulation of inflammation, carbohydrate metabolism, and protein catabolism. Corticosteroids can be administered orally, intravenously, or topically and are used to treat a variety of conditions. Drugs in this class include dexamethasone, methylprednisone, prednisone, hydrocortisone, mometasone, betamethasone, and fludrocortisones. Topical use of specific corticosteroids has been examined for its efficacy in treating radiodermatitis, skin reactions, and mucositis, and in the prevention of bleeding.

Research Evidence Summaries

Raeessi, M.A., Raeessi, N., Panahi, Y., Gharaie, H., Davoudi, S.M., Saadat, A., . . . Jalalian, H. (2014). \"Coffee plus Honey\" versus \"topical steroid\" in the treatment of chemotherapy-induced oral mucositis: A randomised controlled trial. BMC Complementary and Alternative Medicine, 14, 293-6882-14-293.

Study Purpose

To draw a comparison between the therapeutic effects of treatment modalities (topical steroid, honey, honey plus coffee) in patients with oral mucositis

Intervention Characteristics/Basic Study Process

Patients were randomized to one of three groups that each received a 600 g syrup solution. The solution in the steroid group (S) contained 20, 8 mg Betamethasone solution ampoules. The solution in the honey plus coffee group (HC) contained 300 g of honey plus 20 g of instant coffee. The solution in the honey group (H) contained 300 g of honey. Every three hours for one week, patients were instructed to sip 10 ml of their solution and swallow it. Data were collected prior to the initiation of the intervention and one week later. Patients were not allowed to use any other anti-inflammatory agents during the study. Patients and providers were blinded to the groups.

Sample Characteristics

  • N = 75
  • AVERAGE AGE = 55.2 years
  • MALES: 48%, FEMALES: 52%
  • OTHER KEY SAMPLE CHARACTERISTICS: Participants who presented with oral mucositis after chemotherapy during a period of three years at the hospital site; patients with oral mucositis after chemotherapy between 15 and 80 years old


  • SITE: Single-site    
  • SETTING TYPE: Inpatient    
  • LOCATION: Baqiyatallah University Hospital, Tehran, Iran

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment
  • APPLICATIONS: Pediatrics, elder care, palliative care 

Study Design

Double-blinded, randomized clinical trial

Measurement Instruments/Methods

  • The World Health Organization (WHO) oral toxicity scale was used to grade oral mucositis.
  • A physician-rated questionnaire was created and validated for this study (questions not available).


All three regimens significantly reduced oral mucositis at the end of the intervention week (p < .05).


A steroid solution, honey plus coffee solution, or honey only solution reduced the severity of oral mucositis after one week of treatment.


  • Small sample (< 100)
  • Risk of bias (no control group)
  • Risk of bias (no appropriate attentional control condition)
  • Unintended interventions or applicable interventions not described that would influence results
  • Key sample group differences that could influence results
  • Findings not generalizable
  • Other limitations/explanation: The study did not take into account what chemotherapy regimens the participants received or the point in the treatment regimens at which mucositis developed. The study also did not report which disease characteristics the participants had prior to treatment. The study did discuss in great length how each solution was prepared. There was no control group.

Nursing Implications

Further investigation is needed on this intervention taking into account participants' diseases and chemotherapy regimens received.