Intensive Care Med (2018) 44:1153–1155 https://doi.org/10.1007/s00134-018-5221-x EDITORIAL 1,2* 3,4 Lila Bouadma and Michael Klompas © 2018 Springer-Verlag GmbH Germany, part of Springer Nature and ESICM Pneumonia in hospitalized patients is usually induced increase mortality risk [3, 5–7]. The mechanism leading by aspiration of oral pathogens into the lower respira- to higher mortality rates is unclear, but it may be that tory system. Oral care with chlorhexidine for the preven- some patients aspirate chlorhexidine and develop acute tion of pneumonia is an appealing alternative because it respiratory distress syndrome . In addition, some appears to be safe, effective, and less likely to select for patients may suffer allergic reactions, including anaphy - antibiotic resistance than oropharyngeal or digestive laxis [9–11]. decontamination [1, 2]. Finally, the presumption that oral care with chlorhex- The evidence that chlorhexidine is safe and effective, idine has no impact on resistance may be incorrect. however, may be less robust than it seems (Table 1). First, Biocide and antibiotic efflux pump genes are present in our perception that chlorhexidine oral care prevents bacteria and can confer resistance to chlorhexidine; wide- ventilator-associated pneumonia (VAP) may be biased. spread use of chlorhexidine may accelerate the spread While multiple meta-analyses of
Intensive Care Medicine – Springer Journals
Published: May 28, 2018
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