Treatment
Decontamination of the nasopharynx and oropharynx with chlorhexidine reduced nosocomial infections in cardiac surgery
Segers P, Speekenbrink RG, Ubbink DT, et al. Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial. JAMA 2006;296:2460–6.
Q Does perioperative decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate reduce nosocomial infections after cardiac surgery?
Key Words: anti-infective agents (local) • cardiac surgical procedures • chlorhexidine • cross infection • nasopharynx • oropharynx • perioperative care
| The first 150 words of the full text of this article appear below. |
Design:
randomised, placebo-controlled trial.
Allocation:
concealed.
Blinding:
blinded (patients, healthcare providers, data collectors, {outcome assessors, data analysts, safety and monitoring committee, and manuscript writers}*).
Follow-up period:
up to 30 days.
Setting:
a community hospital in the Netherlands.
Patients:
991 patients >18 years of age requiring cardiothoracic surgery. Exclusion criteria included emergency procedures; preoperative infection or use of antimicrobials; hypersensitivity to chlorhexidine; use of an alternative prophylactic regimen; and admission <1 day before surgery.
Intervention:
0.12% chlorhexidine gluconate used as an oral rinse and as a gel for nasal application (n = 500) or placebo (n = 491). 10 ml of oropharyngeal solution was used as a mouth rinse, applied to buccal, pharyngeal, gingival, and tooth surfaces for 30 seconds 4 times/day; nose ointment was applied to both nostrils 4 times/day until the nasogastric tube was removed (usually the day after surgery). All patients were treated using the usual protocol
1 West Virginia University, School of Nursing,
Morgantown, West Virginia, USA
2 University of Auckland,
Auckland, New Zealand
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