Comparison of the Effectiveness of Oral Care with Chlorhexidine and Povidone iodine on the Incidence of Ventilator Associated Pneumonia in ICU – A prospective randomized controlled study

Background: Mechanical ventilation is often required in 10-20% critically ill patients, may be because of respiratory or any other indication. There is always a risk of developing pneumonia in such patients. Any pneumonia developing after 48 hours of commencing mechanical ventilation in a patient with previously non infected lungs is labeled as ventilator associated pneumonia (VAP).It occurs in 9–27% of patients on mechanical ventillation. This study was aimed at comparing the effectiveness of oral care with povidone iodine and chlorhexidine in preventing VAP. Materials and methods: This prospective randomized study included 70 patients in critical care unit requiring mechanical ventilation for more than 72 hrs After obtaining permission from hospital ethical committee and written informed consent from the patients, they were randomly allocated in two groups of 35 each: group I and group II to receive oral care with povidone iodine and chlorhexidine respectively. Development of VAP was recorded on basis of clinical findings, x-ray and tracheal culture. Results &Conclusions: In group receiving oral care with povidone iodine, 6(11.4%) patients developed VAP as compared to chlorhexidine group only 4 (17.1%) patients developed VAP but it did not reach statistical significance. Thus oral care with chlorhexidine is superior in prevention of VAP as compared with povidone iodine mouth wash but more studies need to be done, with larger sample size.