Is Chlorhexidine effective for preventing ventilator-associated pneumonia among ventilated patients in intensive care unit?

Abstract

This systematic review specifically studies the impact of chlorhexidine (CHX) compared to placebo or regular care among ventilated patients in an intensive care unit (ICU). The review focuses on the effectiveness of CHX as a prophylaxis for preventing ventilator-associated pneumonia (VAP). Eight randomised controlled trials (1453 patients) published between 2005 and 2015 were included in the review, following a search of the electronic databases MEDLINE, EMBACE, CINAHL (EBSCOhost), the Cochrane Library Register of Controlled Trials (CENTRAL), Web of Science and Scopus. Different concentrations and frequencies were identified as having been applied in experiments aiming to identify the impact of CHX on VAP incidence. The results of all studies revealed that that CHX is effective as a prophylaxis in preventing VAP. Some studies also noted CHX’s effectiveness in use with gram-positive bacteria. Others indicated that there were no side effect during their trials. However, no significant differences in the duration of mechanical ventilator use or mortality rates were noted among the ventilated ICU patients. This systematic review could be developed further by expanding its inclusion criteria, for example, to compare between CHX and other medications, or by using CHX before intubation to prevent VAP.