Comparison of the Effect of Chlorhexidine Mouthwash and Combined Mouthwash (4 drugs) in Preventing and Managing Oral Mucositis in Neutropenic Patients Admitted to the Pediatric Oncology Department: A Randomized Clinical Trial

Background: Given the lack of comprehensive studies comparing the effects of chlorhexidine and combined mouthwashes in preventing oral mucositis in our country, particularly in Yazd province, this study aims to evaluate the effectiveness of combined mouthwash versus chlorhexidine mouthwash in preventing oral mucositis in neutropenic patients. Materials and Methods: This study was a double-blind randomized controlled trial conducted on children undergoing chemotherapy at Shahid Sadoughi Hospital. Patients were randomly assigned to two groups of 30: one group received combined mouthwash containing diphenhydramine, nystatin, aluminum-magnesium hydroxide, and lidocaine (group 1), while the other group received a 0.2% chlorhexidine mouthwash (group 2). The interventions were administered orally at least twice daily for one month. Results: The frequency of pain intensity and mucositis in the two groups was similar on the 14th and 28th days (100% of patients were free from pain and mucositis). Additionally, no significant difference was observed between the two groups in terms of pain intensity and frequency of mucositis on the 7th and 21th days (p > 0.05). On the 7th day, the frequency of grade 1 mucositis was 3.4% in group 1 and 3.3% in group 2, with no statistically significant difference in the severity of mucositis between the two groups (p = 0.981). On the 21th day, the frequency of grade 3 mucositis was 3.4% in group 1 and 0% in group 2; however, there was no statistically significant difference in the severity of mucositis between the two groups on the 21th day (p = 0.305). Conclusion: Although there was no statistical difference in reducing pain severity, mucositis frequency, or mucositis grade between the two groups, chlorhexidine was found to be more effective and satisfactory in practice. Therefore, considering its lower cost, chlorhexidine is recommended as a cost-effective option for the treatment of oral mucositis.