Chlorhexidine for prophylaxis and tratment of oral complications occuring during cancer chemotherapy

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Klin Onkol 1997; 10(6): 188-191.

Cancer chemotherapy increases the risk of infection. Infection in the oral cavity often is ofter caused by bacteria or fungi. The majority of infections in patients with malignancies are caused by microbes already colonizing the patient. The cytotoxic effects of chemotherapy on replicating oral musosal cells can result in oral mucositis. This drug-induced mucositis represents a portal of infection. Till the present time effective strategies for management of these complications do not exist.

The authors present their experience with use of chlorhexidin (drug speciality Hexoraletten® N, Godecke, D) for prophylaxis and treatment of oral complications occuring during cancer therapy. They analyse anti-bacterial and anti-fungal effects of chlorhexidine.

Twenty patients with hematoooncological diseases and mucositis were examinated. The patients took Hexoraletten® N, 3 lozenges daily. Total length of admission ranged from 4 to 21 days, with an average-length of 10,4 days. After completion of chlorhexidine treatment, reduction of bacterial colonization of the oral cavity was found in 12 patients (60%) and reduction of fungal colonization was found in 8 patients (40%). Increase of bacterial colonization of the oral cavity was found in 1 patient and increase of fungal colonization was found in 3 patients. Compared with the level of oral bacteria before chlorhexidine use, from the 6th day of chlorhexidine treatment a significant reduction of oral bacteria colonization was observed (p<0,001). On the contrary, in case of fungi a significant reduction of oral fungal colonization during chlorhexidine use was not observed. In all cases the side effets of chlorhexidine use were not discovered.