Does chlorhexidine reduce the incidence of ventilator-associated pneumonia in ICU patients? A systematic review and meta-analysis

Abstract

ObjectiveThis study aimed to investigate chlorhexidine’s efficacy in preventing ventilator-associated pneumonia (VAP). DesignA systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. SettingsThe data were obtained from Pubmed, Cochrane Library, and EMBASE. Patients or participantsOnly mechanically ventilated patients for at least 48h were included. InterventionsRandomized clinical trials applying any dosage form of chlorhexidine were eligible. Main variables of interestThe relative risk (RR) of the VAP incidence and all-cause mortality was assessed using the random-effects model. The mean difference in days of mechanical ventilation duration and intensive care unit (ICU) length of stay were also appraised. ResultsTen studies involving 1233 patients were included in the meta-analysis. The oral application of CHX reduced the incidence of VAP (RR, 0.73 [95% CI, 0.55, 0.97]) and did not show an increase in all-cause mortality (RR, 1.13 [95% CI, 0.96, 1.32]). ConclusionsCHX proved effective to prevent VAP. However, a conclusion on mortality rates could not be drawn because the quality of the evidence was very low for this outcome.