In Reply We thank Dr Sherr for his interest in our article1 and agree that it focused more on chemotherapy-induced mucositis than radiation therapy–induced mucositis. Oral mucositis remains an often overlooked and undertreated adverse event of cancer therapy that greatly influences the quality of life of patients.2 In the patient with gastric cancer and capecitabine-induced mucositis described in our article, treatment with magic mouthwash resulted in both physical (loss of taste, oral numbness, and drowsiness) and fiscal (out-of-pocket costs) toxicity. Our concerns over the routine use of magic mouthwash in managing oral mucositis go beyond efficacy alone, which itself has been questionable at best. Other issues include the potential for physical adverse events, financial toxicity, lack of standardization of contents, and unnecessary exposure to steroids and antibiotics.1 Without a fixed “recipe,” the generalizability of studies analyzing the efficacy of magic mouthwash is hindered; perhaps a new standard for magic mouthwash can emerge with the publication of the results of the phase 3 randomized double-blind study3 that Dr Sherr mentions.
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Uberoi AS, Brown TJ, Gupta A. Finding the Magic in Magic Mouthwash—Reply. JAMA Intern Med. 2019;179(5):724–725. doi:10.1001/jamainternmed.2019.0291
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