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Chlorhexidine Reduces Ventilator-Associated Pneumonia

Oral decontamination cuts ventilator-associated pneumonia risk without the drawbacks of antibiotics

FRIDAY, June 16 (HealthDay News) -- The incidence of ventilator-associated pneumonia (VAP) can be reduced by topical application of chlorhexidine into the buccal cavity instead of antibiotics, according to a study published in the June 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Mirelle Koeman, M.D., Ph.D., of the University Medical Center Utrecht in the Netherlands, and colleagues conducted a randomized, double-blind, placebo-controlled study of 385 patients requiring mechanical ventilation who were split into three groups: 127 patients received chlorhexidine (CHX, 2 percent), 128 received CHX/colistin (CHX/COL, 2 percent of each) and 130 received a placebo, applied into the buccal cavity every six hours.

In the CHX group, there was a 65 percent reduction in daily risk of VAP compared with the placebo, while the CHX/COL group showed a 55 percent reduction in daily risk. Treatment with CHX/COL reduced colonization by both gram-negative and gram-positive microorganisms, while CHX predominantly reduced gram-positive microorganisms. The groups had similar results in terms of duration of mechanical ventilation, length of stay in intensive care and intensive care mortality.

"Considering the growing role of COL as ultimate treatment of multiresistant gram-negative bacteria, CHX seems to be preferred for preventive applications. The safety profile regarding selection and induction of antibiotic resistance and the presumed cost benefits of CHX make it highly attractive for prevention of VAP," the authors conclude.

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