Comparison of the antibacterial effects of matrica & PersicaTM and chlorhexidine gluconate mouthwashes in mechanically ventilated ICU patients: a double blind randomized clinical trial

Background & Aim: Accumulation of bacteria in the pharynx is one of the risk factors of pneumonia due to ventilation. One of the methods of prevention from accumulation of bacteria in the pharynx is the use of oral solutions. Chlorhexidine is considered as the gold standard, but it has various side effects. Present study was aimed to determine and compare anti-bacterial effects of the chlorhexidine gluconate 0.2%, herbal mouthwash of matrica (chamomile extracts) 10%, PersicaTM 10% and normal saline in intensive care unit patients. Methods: In this double blind randomized clinical trial, 80 patients who were admitted in ICU divided into four groups of 20 patients each one. Researchers applied PersicaTM to group one, chlorhexidine gluconate mouthwash 0. 2% to group two and third group received matrica, finally in the control group, normal saline were used. In order to culturing of Staphylococcus aureus and Streptococcus pneumoniae, salivary samples were obtained without any stimulation after six minimums oral rinsing. The data were processed in SPSS17 software and analyzed by appropriate statistical tests. Findings: Decreased rate of bacterial colonies after intervention in the whole four groups was significant (p < 0.001). The mouthwash of chlorhexidine (p < 0.001), PersicaTM (p = 0.008) and matrica (p = 0.01) had a significant antibacterial effect on S. aureus and S. pneumoniae (p < 0.001). Conclusion: Herbal oral mouthwash of PersicaTM and matrica has the effect on S. pneumoniae and S. aureus of oropharynx area in mechanical ventilation patients. However, there is a need for further research to be considered as an alternative to chlorhexidine for prevention of VAP in ICU patients.