Chlorhexidine prophylaxis for chemotherapy-and radiotherapy-induced stomatitis: A randomized double-blind trial

Gerald A. Ferretti, Ted P. Raybould, Albert T. Brown, John S. Macdonald, Martha Greenwood, Yosh Maruyama, John Geil, Thomas T. Lillich, Robert C. Ash

Research output: Contribution to journalArticlepeer-review

154 Scopus citations


Patients receiving cytotoxic antineoplastic therapy often have treatment-associated stomatitis. A 0.12% chlorhexidine digluconate mouthrinse was evaluated (15 ml, three times a day) in a prospective, double-blind randomized trial as prophylaxis against cytotoxic therapy-induced damage to oral soft tissues. Seventy subjects, forty inpatients receiving high-dose chemotherapy and thirty outpatients receiving high-dose head and neck radiation therapy, were evaluated. Chlorhexidine mouthrinse significantly reduced the incidence of oral mucositis in the chemotherapy group on day 14 (p < 0.02) and at 1 week follow-up on day 28 (p < 0.002). Mucositis in the patients undergoing chemotherapy who received chlorhexidine also resolved more rapidly. Mucositis severity was significantly less compared to the control chemotherapy group on day 14 (p < 0.03), day 21 (p < 0.04), and on 1 week follow-up (p < 0.02). Concomitant trends in the reduction in oral streptococci and yeast were noted in the chemotherapy group receiving chlorhexidine mouthrinse. Although no differences were observed in oral mucositis between the control and chlorhexidine groups of patients undergoing high-dose radiotherapy, similar reductions of oral microflora to those seen in the chemotherapy population were also noted for patients undergoing radiation therapy who received chlorhexidine. Although generally not significant, some increase in gram-negative bacilli was noted in the chlorhexidine-treated patients in both the chemotherapy and radiotherapy groups, but there was no correlation with increased systemic infection. Prophylactic chlorhexidine mouthrinse reduces oral mucositis and microbial burden in patients with cancer undergoing intensive chemotherapy.

Original languageEnglish
Pages (from-to)331-338
Number of pages8
JournalOral Surgery, Oral Medicine, Oral Pathology
Issue number3
StatePublished - Mar 1990

Bibliographical note

Funding Information:
This study was supported by funds from the University Kentucky, the Procter & Gamble Company, and the Veterans ministration. aDepartment of Oral Health Practice, University bDepartment of Oral Health Practice, University CDepartment of Oral Health Science, University dMarkey Cancer Center, University of Kentucky.

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dentistry (all)


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