Table 1 Characteristics of included randomized controlled trials on topical decontamination by antiseptics

AJ De Riso et al. 1996 [51]

USA

173/180

0.12% CHX^† oral rinse + Standard oral care^‡

Inert solution + Standard oral care^‡

Oropharynx^§

For 30 s 2 times/d

VAP^| In-hospital mortality All ICU^¶-acquired infections

0.35; 0.1 to 1.26 0.21; 0.05 to 0.94 0.36; 0.16 to 0.77

Cardiothoracic ICU^¶

F Fourrier et al. 2000** [52]

France

30/30

0.2% CHX^† gel

Standard oral care^‡

Dental and gingival surfaces

3 times/d

VAP^| Mortality All ICU^¶-acquired infections

0.36; 0.13 to 1.01 0.43; 0.12 to 1.5 10; 2.59 to 42.21

Multidisciplinary ICU^¶

S Houston et al. 2002^†† [53]

USA

270/291

0.12% CHX^† oral rinse

Listerine^‡‡ oral rinse

Oropharynx^§,§§

2 times/d For 10 days or until extubation

VAP^| Mortality

0.48; 0.15 to 1.54 2.16; 0.54 to 8.53

Cardiothoracic ICU^¶

F Fourrier et al. 2005 [54]

France

114/114

0.2% CHX^† gel

Placebo gel

Dental and gingival surfaces

3 times/d until 28 days

VAP^| ICU^¶ mortality All ICU**-acquired infections

1.08; 0.52 to 2.27 1.29; 0.81 to 2.06 1.06; 0.51 to 2.21

Multidisciplinary ICU^¶

P Seguin et al. 2006^†† [55]

France

36/62

10% povidone-iodine oral rinse+ aspiration of oropharyngeal secretions

31 saline group^|| 31 control group^¶¶

Oropharynx^§ and nasopharynx

Every 4 hours

VAP^| ICU^¶ mortality

0.21; 0.07 to 0.64 0.65; 0.28 to 1.5

Surgical ICU^¶

P Segers et al. 2006 [56]

Netherland

485/469

0.12% CHX^† oral rinse and nasal gel

Placebo oral rinse and nasal gel

Oropharynx^§ and nasal cavities

Oral rinse for 30 s 4 times/d; nasal gel 4 times/d

VAP^| In-hospital mortality All ICU^¶-acquired infections

0.59; 0.42 to 0.83 1.1; 0.39 to 3.15 0.58; 0.44 to 0.78

Cardiothoracic ICU^¶

M Koeman et al. 2006 [57]

Netherland

127/130

2% CHX^† in vaseline

Vaseline

Buccal cavity

4 times/d

VAP^| ICU^¶ mortality

0.58; 0.31 to 1.09 1.12; 0.72 to 1.17

Multidisciplinary ICU^¶

H Tantipong et al. 2008^†† [32]

Thailand

102/105

Oral care^††† with 2% CHX^† solution

Oral care***with normal saline solution

Oropharynx^§

4 times/d

VAP^| Mortality

0.58; 0.27 to 1.22 1;0.75 to 1.34

Multidisciplinary ICU^¶ General medical ward

F Bellissimo-Rodrigues et al. 2009 [33]

Brazil

98/96

0.12% CHX^† oral rinse

Placebo oral rinse

Buccal cavity

3 times/d until ICU discharge

VAP^| ICU^¶ mortality

0.91; 0.39 to 2.06 1.06; 0.56 to 1.99

Multidisciplinary ICU^¶

TS Panchabhai et al. 2009^†† [34]

India

88/83

Cleansing^†††with 0.2% CHX^† + normal saline solution

Cleansing^†††with 0.01% PP^‡‡‡+ normal saline solution

Oropharynx^§ and hypopharynx

2 times/d until ICU discharge or death

VAP^| In-hospital mortality

0.88; 0.45 to 1.71 1.18; 0.96 to 1.46

Multidisciplinary ICU^¶

CL Munro et al. 2009^†† [35]

USA

44/51

0.12% CHX^† oral swab

Oral care (not specified)

Buccal cavity

2 times/d

In-hospital mortality

1.96; 0.67 to 5.87

Multidisciplinary ICU^¶

F Scannapieco et al. 2009 [36]

USA

116^§§§/59

Standard oral care^|||+ 0.12% CHX^† oral rinse

Standard oral care^|||+ Placebo oral rinse

Buccal cavity

2 times/d

VAP^| ICU^¶ mortality^¶¶¶

0.54; 0.23 to 1.25 1.01; 0.37 to 2.97

Trauma ICU^¶