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Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients
Author(s) -
Spijkervet Fred K. L.,
Van Saene Hendrik K. F.,
Van Saene Joris J. M.,
Panders Arend K.,
Vermey Albert,
Mehta Dinesz M.,
Fidler Vasek
Publication year - 1991
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930460309
Subject(s) - mucositis , medicine , head and neck cancer , chlorhexidine , tobramycin , placebo , bacilli , cancer , gastroenterology , lozenge , surgery , antibiotics , microbiology and biotechnology , chemotherapy , dentistry , pathology , bacteria , biology , history , genetics , alternative medicine , archaeology , gentamicin
Abstract Recently it has been reported that chlorhexidine 0.1 % rinsing was not successful in eradication of gram‐negative bacilli in patients who have head and neck cancer. These bacilli could play a role in irradiation mucositis. This study reports the effect of lozenges containing 2 mg polymyxin E, 1.8 mg tobramycin, and 10 mg amphotericin B qid on the oropharyngeal flora in 15 irradiated head and neck cancer patients. The results were compared with those of a previous study in two groups of 15 patients comparing chlorhexidine rinsing with placebo. In all patients using lozenges, eradication of gram‐negative bacilli and yeasts was achieved within 3 weeks. A significant increase of enterococci was found. Mucositis was significantly reduced compared with the previous two groups. All patients showed erythema only, whereas 80% of both the placebo and chlorhexidine rinsing patients suffered from severe mucositis, with signs of pseudomembranes developing from the third week of conventional irradiation protocol. The effect of selective elimination of gram‐negative bacilli from the oropharynx and the prevention of severe mucositis may be explained by the eradication of these bacteria and/or neutralization of salivary endotoxin, released by gram‐negative bacilli, mediating the inflammatory processes.