The results appeared in the second issue for June 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Mirelle Koeman, M.D., Ph.D., of the Department of Emergency Medicine and Infectious Diseases at the University Medical Center Utrecht in the Netherlands, and 13 associates used chlorhexidine as an oral decontaminant paste to treat 127 intubated ventilated patients. The investigators treated a separate group of 128 ventilated patients with a paste composed of chlorhexidine and the antibiotic colistin. A third group of 130 ventilated patients were given a placebo paste.
In comparison to the placebo, the chlorhexidine paste reduced the risk of ventilator-associated pneumonia by 65 percent and the chlorhexidine/colistin combination cut the risk by 55 percent.
All 385 patients who were enrolled consecutively in the study needed mechanical ventilation for 48 hours or more at two university hospitals and three general hospitals in the Netherlands.
According to the authors, ventilator-associated pneumonia is second only to urinary infection as a hospital-acquired illness. The disease affects 27 percent of all critically-ill ventilated patients. Crude mortality rates from ventilator-associated pneumonia range from 20 to 60 percent, and resulting health care costs can be anywhere from $12,000 to $40,000 per patient.
The bacteria that cause ventilator-associated pneumonia usually originate in the mouth and throat. Mechanically ventilated patients have a catheter called an endotracheal tube inserted through either their nose or mouth into the windpipe (trachea) to maintain an open airway, to deliver oxygen, and to suction mucus. The endot
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American Thoracic Society