Comparison of 0.2% Chlorhexidine Mouthwash with 1% Povidone Iodine in Preventing the Incidence of Early Ventilator Acquired Pneumonia in the Intensive Care Unit of RSUP Haji Adam Malik Medan

Background: Intensive Care Unit (ICU) is a ward that is prone to nosocomial infections. Mechanical ventilation (MV) support is often required by 10-20% of patients admitted to the ICU, where there is always a risk of developed Ventilator-Acquired Pneumonia (VAP). Poor oral hygiene can lead to bacterial colonization of the oropharynx and aspiration of oropharyngeal secretions into the lower respiratory tract is a major factor in the occurrence of VAP. In addition, VAP is an important cause of morbidity, increased use of health resources, increased length of ICU stay and costs. Therefore, since 2003, various efforts have been made to reduce the incidence of VAP in the ICU, one of which is the use of antiseptic mouthwash which is expected to reduce the incidence of VAP. Objective: Obtain the results of chlorhexidine 0,2% mouthwash compared to povidone iodine 1% mouthwash in preventing the incidence of Early VAP in RSUP Haji Adam Malik Medan. Methods: The research design is randomized clinical trial with a single blind method. After obtaining approval from the Ethics Committee of the Faculty of Medicine, Universitas Sumatera Utara, Medan, 40 research samples were collected which, after fulfilling the inclusion criteria, were randomly divided into 2 groups. Group A received chlorhexidine 0,2% and group B received povidone iodine 1%. The research data obtained were tested using SPSS. Results: CPIS value < 6 at 48 hours was higher in the 0.2% chlorhexidine group than the 1% povidone iodine group, but not statistically significant (p = 0.170). The most common distribution of germs found were Acinetobacter baumanii and Pseudomonas aeruginosa. Conclusion: The incidence of Early VAP appeared to be less in the group receiving 0.2% chlorhexidine mouthwash compared to the 1% povidone iodine group but not statistically significant. In the 0.2% chlorhexidine group, the incidence of Early VAP was 22.5%. In the 1% povidone iodine group, the incidence of Early VAP was 32.5%. The distribution of germs obtained from the culture results shows that Acinetobacter baumanii and Pseudomonas aeruginosa are still the main causes of VAP in the ICU of Haji Adam