Skip to main content

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

From: Prevention of ventilator-associated pneumonia, mortality and all intensive care unit acquired infections by topically applied antimicrobial or antiseptic agents: a meta-analysis of randomized controlled trials in intensive care units

Authors Country Units of treatment T/C* Interventions Delivery mode Daily amount and timing Outcomes Odds Ratio; 95% Confidence Interval Population
    Treatment Control      
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
  1. * Treatment/control
  2. chlorhexidine gluconate
  3. mouth rinsing with bicarbonate isotonic serum followed by oropharyngeal aspiration four times a day
  4. § buccal, pharyngeal, gingival, tongue and tooth surfaces
  5. | ventilator associated pneumonia
  6. intensive care units
  7. **single blind randomized study
  8. †† not blind randomized study
  9. ‡‡ phenolic mixture
  10. §§patients received 15 ml of the experimental or the control drug preoperatively
  11. ||saline solution oral rinse followed by oropharyngeal aspiration
  12. ¶¶regimen without any instillation but with aspiration of oropharyngeal secretions only
  13. *** patients received teeth brushing, oral secretions suctioning and the oropharyngeal mucosa rubbing with solution
  14. ††† oropharyngeal secretion suction and swab of the oral cavity, teeth, palate, buccal spaces, posterior pharyngeal wall and hypopharynx with normal saline solution followed by the same procedure with one of the two study solutions
  15. ‡‡‡potassium permanganate
  16. §§§two arms in treatment group: 58 patient received once daily chx and once daily placebo; 58 patients received twice daily chx
  17. |||suction toothbrush twice a day and swabbing every four hours
  18. ¶¶¶treatment group: 97; control group: 49