The Difference in Mouthwash Side Effects of Persica and Chlorhexidine for Preventing Ventilator-induced Pneumonia among Patients Admitted to the Intensive Care Unit

Abstract

Background: Pneumonia is a common cause of morbidity and mortality in ICU patients under mechanical ventilation. In recent years the use of herbal mouthwashes, due to antimicrobial effects and fewer side effects, has been studied in reducing the incidence of ventilator-associated pneumonia (VAP). In this study, the effect of Persica mouthwash in the prevention of VAP in ICU patients was compared with chlorhexidine. Methods: This study is a double-blind, randomized clinical trial among ICU patients under mechanical ventilation. Fifty patients were divided into two groups, the control group used 10 ml Chlorhexidine 2.0%, and the intervention group used 10cc Persica as a mouthwash. The incidence of pneumonia, mortality, length of hospital stays, mechanical ventilation duration, CPIS (Clinical Pulmonary Infection Score), and SOFA (sequential organ failure assessment) score and complications were evaluated among the two groups. Results: The incidence of pneumonia, mortality, SOFA score, and CPIS in the two groups were not significantly different. Length of stay in the ICU and mechanical ventilation duration were also not significantly different in the two groups, p>0.05. Side effects with chlorhexidine were significantly more often than Persica (44% vs. 8%) p=0.008. Conclusion: The incidence of early pneumonia in patients with no baseline pneumonia did not differ with Persica and Chlorhexidine mouthwash. At the same time, the incidence of side effects caused by the use of Persica was significantly less. Clinical Trial Registrations No.: RCT2017022032676N1.