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Effects of daily oral care with 0.12% chlorhexidine gluconate and a standard oral care protocol on the development of nosocomial pneumonia in intubated patients: a pilot study.

Author(s): Bopp M, Darby M, Loftin KC, Broscious S

Affiliation(s): Gene W. Hirschfeld School of Dental Hygiene, Old Dominion University, Norfolk, VA, USA.

Publication date & source: 2006-06, J Dent Hyg., 80(3):9. Epub 2006 Jul 1.

Publication type: Randomized Controlled Trial

PURPOSE: The purpose of this pilot study was to determine if a difference existed between nosocomial pneumonia rates for intubated critical care unit (CCU) patients who received twice-daily oral hygiene care with 0.12% chlorhexidine gluconate and those who received the standard oral care. METHODS: Over seven months (February to August), CCU patients were identified through screening and informed consent procedures, and randomized into 1 of 2 groups. Over the 7 months, due to the critically ill nature of the patients, only 5 subjects were enrolled. While in the study, twice-daily oral hygiene care consisted of brushing the cheeks, teeth, and endotracheal tube with a suctioning toothbrush using an FDA-approved 0.12% chlorhexidine gluconate antimicrobial agent with the experimental group (2 intubated patients in the CCU). The control group (3 intubated patients in the CCU) received the standard oral care 6 times per day utilizing a soft foam swab and half strength hydrogen peroxide. All oral care was performed by the nursing staff. The number of persons developing nosocomial pneumonia was monitored until hospital discharge. RESULTS: Results revealed that 1 person out of 3 in the control group was discharged from the hospital with a diagnosis of nosocomial (aspiration) pneumonia. Neither of the 2 subjects in the experimental group was diagnosed with nosocomial pneumonia. Preliminary findings suggest that twice-daily oral hygiene care with 0.12% chlorhexidine gluconate may reduce the risk of nosocomial pneumonia in intubated patients more than the 6-times daily standard oral care protocol. The standard oral care protocol does not include the use of an FDA-approved antimicrobial solution. However, the small size of the sample makes this finding inconclusive. CONCLUSION: Twice-daily oral hygiene care with 0.12% chlorhexidine gluconate may hold promise as a nosocomial pneumonia reduction strategy within hospital CCUs; however, its application requires further testing.

Page last updated: 2006-11-05

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