Chamomile mouthwash for prevention of chemotherapy-induced oral mucositis: A prospective cohort study in a pharmacist-led supportive care setting

Chemotherapy-induced oral mucositis (OM) is a common and distressing complication of cancer treatment, significantly impacting patients’ quality of life. Chamomile ( Matricaria recutita L.), known for its anti-inflammatory and wound-healing properties, may offer a natural and accessible preventive option. This study aimed to evaluate the efficacy of a chamomile infusion mouthwash in preventing OM among chemotherapy-naïve patients. A prospective cohort study included 72 patients initiating chemotherapy. Participants were allocated to two groups: one using a chamomile mouthwash (standardized infusion, three times daily) and a control group with no mouthwash. OM severity was assessed on day 21 using the WHO oral mucositis grading scale. Multivariate analysis identified independent protective factors. The incidence of OM was significantly lower in the chamomile group (5.4%) compared to controls (26.5%, p = 0.016). No severe cases (grade ≥3) occurred in the chamomile group. Multivariate analysis confirmed chamomile mouthwash as an independent protective factor (aOR = 0.184; 95% CI: 0.036–0.941; p = 0.042). Chamomile mouthwash is a simple, well-tolerated, and cost-effective intervention for preventing OM in patients receiving chemotherapy. These findings support its potential role in supportive cancer care. Further randomized controlled trials are warranted to validate these results and optimize administration protocols.