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Oral Rinse Cuts Nosocomial Infection After Cardiac Surgery

Decontamination of nasopharynx and oropharynx seems to decrease respiratory and surgical site infections

TUESDAY, Nov. 21 (HealthDay News) -- Cardiac surgery patients who undergo chlorhexidine gluconate decontamination of the nasopharynx and oropharynx have lower rates of post-surgery nosocomial infections, including lower respiratory tract and surgical site infections, according to the results of a study published in the Nov. 22/29 issue of the Journal of the American Medical Association.

Patrique Segers, M.D., of the University of Amsterdam in the Netherlands, and colleagues evaluated the incidence of nosocomial infection, the Staphylococcus aureus rate in the nasal carriage, as well as the length of hospitalization in 954 patients (485 chlorhexidine group, 469 controls) having open heart surgery between August 2003 and September 2005. Patients used an oral rinse and nose ointment four times daily from the time they entered the hospital to soon after the surgery.

In the chlorhexidine gluconate group, 96 patients (19.8 percent) had 116 nosocomial infections compared to 123 controls (26.2 percent) who had 164 infections. The lower respiratory tract infection rate was 9.3 percent in the treated group and 15.8 percent for controls, resulting in an absolute risk reduction of 6.5 percent. The rate of surgical site infection was not significantly different. However, nine treated patients (1.9 percent) had deep surgical site infections compared to 24 controls (5.1 percent), a 3.2 percent absolute risk reduction. Hospitalization was 9.5 days for the treated patients and 10.3 days for controls.

"This safe and inexpensive disinfectant is effective in decontaminating the nasopharynx and oropharynx…and should be considered in the preoperative preparation of a patient undergoing cardiac surgery," the authors conclude.

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