The effect of polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair) on oral microbial colonization and pain control compared with other rinsing solutions in patients with oral mucositis after allogeneic stem cells transplantation

Med Sci Monit. 2011 Oct;17(10):CR572-6. doi: 10.12659/msm.881983.

Abstract

Background: Gelclair is an oral lubricating gel used in the management of oral mucositis (OM). We evaluated its efficacy, tolerance and impact on oral cavity microbial colonization in patients with OM after allogeneic hematopoietic stem cells transplantation.

Material/method: Gelclair was administered in a group of 22 patients with active OM. A control group of 15 patients used other rinsing solutions (chlorhexidine, benzydamine, salvia). Tests with oral cavity swabs for microbiology analysis were performed once a week.

Results: The characteristics of OM in both groups were comparable, and rinsing solutions had satisfactory tolerability. There was no difference in the median improvement of oral intake and OM-related pain relief, which was assessed mostly as "slight effect". In the Gelclair group, the effect duration was longer (median 3 [0-5] vs. 1 [0-3] hours, p = 0.001). There was significant increase of Enterococcus faecalis and Candida sp. colonization of the oral cavity over the course of the hospitalization and significantly reduced incidence of such colonization in patients with OM in the Gelclair group: 1/22 (5%) vs. 6/15 (40%), p = 0.01. In vitro tests showed inhibited growth of Enterococcus faecalis and Candida sp. colonies within the area of the Gelclair application.

Conclusions: Gelclair may be individually helpful in the management of OM and pain in patients after allogeneic stem cells transplantation. Its use did not lead to worsened oral bacterial and yeast colonization and probably even helped to protect mucosa from Enterococcus and Candida sp. Further studies based on larger cohorts are needed.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Benzydamine
  • Candida / drug effects*
  • Chlorhexidine
  • Drug Combinations
  • Enterococcus faecalis / drug effects*
  • Facial Pain / drug therapy
  • Facial Pain / etiology
  • Humans
  • Hyaluronic Acid / pharmacology*
  • Hyaluronic Acid / therapeutic use
  • Povidone / pharmacology*
  • Povidone / therapeutic use
  • Prospective Studies
  • Stem Cell Transplantation / adverse effects*
  • Stomatitis / drug therapy*
  • Stomatitis / etiology
  • Stomatitis / microbiology*
  • Time Factors
  • Transplantation, Homologous / adverse effects*

Substances

  • Drug Combinations
  • Gelclair
  • Benzydamine
  • Hyaluronic Acid
  • Povidone
  • Chlorhexidine