The Impact of Chlorhexidine Mucoadhesive Gel in the Prevention of Ventilator-Associated Pneumonia: A Randomized Clinical Trial.

Abstract

Objective: Ventilator-associated pneumonia is the common cause of morbidity and mortality in the intensive care unit. Due to the antimicrobial effect of chlorhexidine, and the long-lasting result of mucoadhesive drugs, this study aimed to determine the effect of chlorhexidine mucoadhesive gel on the prevention of ventilator-associated pneumonia in critical patients.

Method: In this clinical trial, 64 ventilated patients were selected and randomly allocated into two groups. The first group received 0.2% chlorhexidine mucoadhesive gel and the second group received 0.2% chlorhexidine solution as a mouthwash. Every three days, the incidence of ventilator-associated pneumonia was evaluated by the clinical score of pulmonary infection. The data were analyzed by SPSS statistical software version 20.

Results: There was no statistically significant difference in demographic characteristics between the two groups. In the control group, 25% of the patients had ventilator-associated pneumonia, while it was only 15.6% in the intervention group; however, the incidence of ventilator-associated pneumonia revealed no significant difference between the two groups (HR ratio, 0.86; 95% confidence interval, 0.49 to 1.83 p =0.356).In addition, there was no statistically significant difference between the number of days connected to the ventilator (p =0.854), the number of days hospitalized in the intensive care unit (p =0.423), and the death rate (p =0.634) between the two groups.

Conclusion: Although no significant statistical difference was detected between chlorhexidine mucoadhesive gel and chlorhexidine solution in the prevention of ventilator-associated pneumonia, the incidence of pneumonia in the mucoadhesive gel group was clinically less than in the control group. It is better to repeat the study with a larger statistical population.