The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

Sharif-Abdullah, Sharifah Shafinaz Binti; Chong, Mei Chan; Surindar-Kaur, Surat Singh; Kamaruzzaman, Shahrul Bahyah; Ng, Kwan Hoong

doi:10.11622/smedj.2016091

Cited by 25 publications

(32 citation statements)

References 20 publications

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“…The studies of Sharif-Abdullah et al 12 and Scannapieco et al 13 had similar conclusions in reducing oral colonization by bacterias. The first one used chlorhexidine 0.2%, 12 and the second one 13 used chlorhexidine 0.12%. Both 12,13 reported that the use of chlorhexidine reduced oral colonization.…”

Section: Discussionmentioning

confidence: 70%

“…There is no standardized methodology that allows it. Nevertheless, those that aimed to compare the reduction of pneumonia incidence or microbial reduction, 12,14,16,18,19 didn't present statistically significant conclusion that the oral hygiene can reduce the incidence of aspiration pneumonia, except the study of Vidalet al 4 These results agree with a systematic review on oral hygiene and pneumonia in children in ICU 11 which concluded that there is no scientific evidence to support the use of oral hygiene isolated with chlorhexidine to prevent PVA. Overall, there are no well-established protocols that aim the best method of oral hygiene for children admitted to ICU.…”

Section: Discussionmentioning

confidence: 86%

“…The main prevention cited by the revised studies is the oral hygiene through mouthwash with antimicrobials and/or mechanical brushing. 4,[12][13][14][15][16][17][18][19][20][21][22] The studies of Vidal et al, 4 Sharif-Abdullah et al 12 and Scannapieco et al 13 had evidence level I and followed almost every criteria. 8 A estudy 4 did not report the sample calculation which is very important to determine the amount needed to compose the sample in order to obtain valid results, but, no more than enough.…”

Section: Discussionmentioning

confidence: 99%

“…The first one used chlorhexidine 0.2%, 12 and the second one 13 used chlorhexidine 0.12%. Both 12,13 reported that the use of chlorhexidine reduced oral colonization. A estudy 13 reported the reduction only of S. aureus and other 12 stated positive effect in reducing oral colonization when compared with oral care routine.…”

Section: Discussionmentioning

confidence: 99%

“…All studies with level of evidence I 4,12,13 reported losses in follow-up. When there are losses of contact with some participants, the researchers cannot complete the collection of data as planned.…”

Section: Discussionmentioning

confidence: 99%

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Pneumonia por aspiração e saúde bucal: uma revisão crítica da literatura

Nascimento

Gonçalves

Oliveira

et al. 2018

Rev. Bras. Odontol.

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Objetivo: identificar evidências na literatura científica se a higiene bucal mecânica ou química pode prevenir a pneumonia aspirativa em pacientes hospitalizados. Material e Métodos: foram incluídos estudos clínicos indexados nas bases de dados Pubmed, Lilacs e Scielo de 2008 a 2017, seguindo critérios pré-determinados de inclusão e exclusão. Resultados: doze estudos preencheram os critérios de inclusão e foram revisados. De acordo com a qualidade das evidências, três estudos foram avaliados como I, seis como II e três como III. Em relação ao tratamento utilizado, pesquisas clínicas investigaram a efetividade de diferentes soluções antimicrobianas para higiene bucal com o objetivo de reduzir a pneumonia aspirativa em pacientes hospitalizados. Diferentes concentrações de clorexidina (0,05%, 0,1%, 0,12%, 0,2%, 2%) foram utilizadas, assim como outras substâncias para bochechos. Conclusão: a falta de estudos de alta qualidade compromete a confiança na eficácia das soluções antimicrobianas na redução da pneumonia aspirativa. Entretanto, aqueles estudos com boa metodologia sugeriram a redução da pneumonia pela higiene bucal.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Pneumonia por aspiração e saúde bucal: uma revisão crítica da literatura

Nascimento

Gonçalves

Oliveira

et al. 2018

Rev. Bras. Odontol.

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Randomized Controlled Trials in Geriatric Dentistry

Desai,

Marchini,

Childs

et al. 2024

Randomized Controlled Trials in Evidence-Based Dentistry

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Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study

et al. 2018

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PurposeChlorhexidine oral care is widely used in critically and non-critically ill hospitalized patients to maintain oral health. We investigated the effect of chlorhexidine oral care on mortality in a general hospitalized population.MethodsIn this single-center, retrospective, hospital-wide, observational cohort study we included adult hospitalized patients (2012–2014). Mortality associated with chlorhexidine oral care was assessed by logistic regression analysis. A threshold cumulative dose of 300 mg served as a dichotomic proxy for chlorhexidine exposure. We adjusted for demographics, diagnostic category, and risk of mortality expressed in four categories (minor, moderate, major, and extreme).ResultsThe study cohort included 82,274 patients of which 11,133 (14%) received chlorhexidine oral care. Low-level exposure to chlorhexidine oral care (≤ 300 mg) was associated with increased risk of death [odds ratio (OR) 2.61; 95% confidence interval (CI) 2.32–2.92]. This association was stronger among patients with a lower risk of death: OR 5.50 (95% CI 4.51–6.71) with minor/moderate risk, OR 2.33 (95% CI 1.96–2.78) with a major risk, and a not significant OR 1.13 (95% CI 0.90–1.41) with an extreme risk of mortality. Similar observations were made for high-level exposure (> 300 mg). No harmful effect was observed in ventilated and non-ventilated ICU patients. Increased risk of death was observed in patients who did not receive mechanical ventilation and were not admitted to ICUs. The adjusted number of patients needed to be exposed to result in one additional fatality case was 47.1 (95% CI 45.2–49.1).ConclusionsThese data argue against the indiscriminate widespread use of chlorhexidine oral care in hospitalized patients, in the absence of proven benefit in specific populations.Electronic supplementary materialThe online version of this article (10.1007/s00134-018-5171-3) contains supplementary material, which is available to authorized users.

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The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

Cited by 25 publications

References 20 publications

Pneumonia por aspiração e saúde bucal: uma revisão crítica da literatura

Pneumonia por aspiração e saúde bucal: uma revisão crítica da literatura

Randomized Controlled Trials in Geriatric Dentistry

Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study

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