Chlorhexidine vs Lactobacillus Plantarum for Oral Care in Intubated ICU Patients

2014-07-23 21:09:31 | BioPortfolio


Critically ill patients often need ventilatory support through a plastic tube connected to a ventilator. Those patients have a altered microbiological flora in the mouth, oropharynx as well as throughout the intestine. Bacteria that can cause illness are often found in the oropharynx in such patients and measures are taken in order to reduce the risk of secondary infections by those bacteria. In all intensive care patients oral care is provided by the nursing staff aiming at a reduction of the pathogenic species. This is done by a variety measures.

Chlorhexidine (CHX) is an antisepticum with a capability to reduce bacterial counts in the mouth and oropharynx and has been shown to be of value also for intubated patients. It is used frequently throughout the world.

Ventilator-associated pneumonia (VAP) is a costly rather frequent complication to intensive care and mechanical ventilation and is usually caused by aspiration of infected secretions from the oropharynx. CHX has in some studies been shown to reduce the frequency of VAP.

The probiotic bacterium Lactobacillus plantarum 299 has the ability to adhere to the mucosa throughout the gastro-intestinal tract including the mouth and in our pilot study we found that L plantarum had better ability to reduce colonisation with enteric bacteria in the oropharynx than CHX had. Figures not statistical significant so this present study is aiming to get a larger amount of data.

The procedure was found to be safe Hypothesis: Lactobacillus plantarum is better than CHX for the reduction of pathogenic bacteria in the oropharynx in intubated mechanically ventilated patients and consequently has a better potential to reduce the frequency of VAP


This study is an expansion of a pilot study performed at the ICU Lund University Hospital, Sweden where 50 patients were included (ISRCTN00472141).

Results have been published in Critical Care 2008, 12:R136 The protocol is the same and in this second phase we intend to include 100 patients and results will be summed up.

Three centres are engaged. The results from the pilot study is encouraging and we are aiming at getting statistical significance in the differences in pathogenic findings in the cultures from oropharynx and also better a better basis for the calculation of the number of patients needed to get sufficient power to study difference in VAP frequency.

Study Design

Allocation: Randomized, Control: Active Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention


Pathogenic Bacteria in the Oropharynx


Lactobacillus plantarum 299 for oral care, Chlorhexidine for standard oral care


Intensive Care Unit, Halmstad Central Hospital
SE 301 85




Region Skane

Results (where available)

View Results


Published on BioPortfolio: 2014-07-23T21:09:31-0400

Clinical Trials [10248 Associated Clinical Trials listed on BioPortfolio]

Stepped Wedge Cluster Randomized Controlled Trial of the De-adoption of Oral Chlorhexidine Prophylaxis and Implementation of an Oral Care Bundle

The objective of the CHORAL study is to evaluate the de-adoption of oral chlorhexidine and the introduction of a bundle of oral care practices on selected outcomes in critically ill mechan...

Lactobacillus Plantarum P8 for Its Brain Health Promotion Potential

This project aims to study the benefits of probiotics namely Lactobacillus plantarum P8 for brain health properties, primarily alleviation of stress, among adults in Malaysia aged from 18 ...

Lactobacillus Plantarum DR7 for Gut-Brain-Axis Benefits

This project aims to study the benefits of probiotics namely Lactobacillus plantarum DR7 for brain health properties, primarily alleviation of stress, among adults in Malaysia aged from 18...

Lactobacillus Plantarum 3547 Effects Over Inflammatory and Immunologic Markers

The purpose of this study is to evaluate the effects of the probiotic Lactobacillus plantarum 3547 over different inflammation and immune system markers on a healthy middle-aged group.

Probiotic Use in Children Undergoing Hematopoietic Stem Cell Transplantation (HSCT) - A Pilot Study

Primary Objective: 1. To evaluate the safety of orally administered Lactobacillus plantarum strains 299 and 299v, a probiotic, in patients undergoing allogeneic myeloablative HSCT,...

PubMed Articles [19971 Associated PubMed Articles listed on BioPortfolio]

Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient? A multicentre, prospective, randomised controlled open trial.

Pathogenic enteric bacteria aspirated from the oropharynx are the main cause of ventilator-associated pneumonia (VAP). Using chlorhexidine (CHX) orally or selective decontamination has been shown to r...

In Vitro Antimicrobial Effect of Bioadhesive Oral Membrane with Chlorhexidine Gel.

This study aimed to evaluate in vitro the antimicrobial effect of a bioadhesive chitosan-based oral membrane with chlorhexidine for local treatment of infections in the oral tissues. Five oral membran...

Use of Chlorhexidine to Prevent Ventilator-Associated Pneumonia in a Long-term Care Setting: A Retrospective Medical Record Review.

The purpose of this study was to explore the use of the oral decontamination solution chlorhexidine (CHX) to reduce ventilator-associated pneumonia (VAP) in a long-term ventilator care setting over ti...

Oral Care Protocols With Specialty Training Lead to Safe Oral Care Practices and Reduce Iatrogenic Bleeding in Extracorporeal Membrane Oxygenation Patients.

Oral care, using either a mouth rinse, gel, toothbrush, or combination of them, together with aspiration of secretions, may reduce the risk of ventilator-acquired pneumonia in intubated patents. Oral ...

Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation.

This study was to assess the effectiveness of a conventional oral hygiene care programme (COHCP) and an advanced oral hygiene care programme (AOHCP) on prevalence and viable counts of oral opportunist...

Medical and Biotech [MESH] Definitions

Organization of medical and nursing care according to the degree of illness and care requirements in the hospital. The elements are intensive care, intermediate care, self-care, long-term care, and organized home care.

A species of Lactobacillus that occurs in the human GASTROINTESTINAL TRACT and ORAL MUCOSA. It produces BACTERIOCINS and is used as a PROBIOTIC.

A disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque.

A species of Lactobacillus that occurs in the human ORAL MUCOSA; GASTROINTESTINAL TRACT; and VAGINA. It produces BACTERIOCINS, can modulate the immune response, and is used as a PROBIOTIC.

A branch of dentistry dealing with diseases of the oral and paraoral structures and the oral management of systemic diseases. (Hall, What is Oral Medicine, Anyway? Clinical Update: National Naval Dental Center, March 1991, p7-8)

More From BioPortfolio on "Chlorhexidine vs Lactobacillus Plantarum for Oral Care in Intubated ICU Patients"

Quick Search


Relevant Topic

Pulmonary relating to or associated with the lungs eg Asthma, chronic bronchitis, emphysema, COPD, Cystic Fibrosis, Influenza,  Lung Cancer, Pneumonia, Pulmonary Arterial Hypertension, Sleep Disorders etc Follow and track Lung Cancer News ...

Searches Linking to this Trial