Mark Jay M Robles and Jay S Fonte
Ospital ng Makati, Internal Medicine, Makati City, Philippines
University of Santo Tomas Hospital, Espana, Manila, Philippines
Scientific Tracks Abstracts: J Pulm Respir Med
Introduction & Objective: Ventilator Associated Pneumonia (VAP), defined as pneumonia occurring more than 48 hours
after patients have been intubated and received mechanical ventilation, represents one of the most important nosocomial
infections in critically ill patients. Chlorhexidine, an antiseptic solution, is a safe and effective product with broad antiseptic
activity. This meta-analysis would like to investigate if chlorhexidine bathing significantly reduced the incidence of ventilator
associated pneumonia.
Method: We searched PubMed and Cochrane Central Register database to check for all published studies related to the
reduction of VAP with application of chlorhexidine bath versus control. Various study designs such as randomized controlled
trials, before-and-after study were included in this meta-analysis.
Results: This meta-analysis analyzed eight studies. One hundred thirty nine (139) events developed in the chlorhexidine group
over 33,030 patient-days which were significantly lower compared to 183 in the soap and water group over 35,213 patient-days.
The overall incidence of ventilator associated pneumonia with the application of chlorhexidine was significantly reduced by
23% with a pooled Risk Ratio (RR) of 0.77 with 95% Confidence Interval (CI): 0.62-0.96; I2=52%. In the subgroup analysis, a
more significant outcome was observed using before-and-after study as the research design (pooled RR 0.63, 95% Confidence
Interval (CI): 0.48-0.83, I2=31%). Daily chlorhexidine bath generated a more favorable outcome, compared to every other day
application as evident on the pooled RR 0.78, 95% Confidence Interval (CI): 0.62- 0.98, I2=59%.
Conclusion: This meta-analysis clearly favors the use of daily chlorhexidine bath in the prevention of ventilator associated
pneumonia.
Mark Jay M Robles is working as medical practioner in Ospital ng Makati on internal Medicine at Makati city and Jay S Fonte is working as Principal Investigator, Senior Fellow, Section of Endocrinology and Metabolism at University of Santo Tomas, Manila, Philippines.
E-mail: mark_robles02@yahoo.com
Pulmonary & Respiratory Medicine received 1690 citations as per Google Scholar report