Munro (1) researched mechanical, pharmacological, and oral care on occurrence of ventilator-related pneumonia in patients undergoing mechanical ventilation. In the methodology, patients undergoing treatment in intensive care units were involved in a day of intubation into controlled clinical trials which were randomized. The trials were more of a two by two factorial in design. Edentulous and pneumonia patients did not take part in the study. Patients who had been clinically diagnosed with pneumonia at the onset of intubation were excluded likewise to edentulous patients. A total of 547 patients were assigned randomly to one to four treatments. An oral swab having 0.12 percent chlorhexidine was applied two times a day. Brushing of tooth was done thrice in a day. There was no significant difference in clinical characteristics of the four treatments. Patients, who had no pneumonia initially, contract pneumonia by day three. This becomes 24 percent of those treated with chlorhexidine. After analyzing data on all patients, the outcome indicated chlorhexidine or tooth brushing had no effect. Pneumonia incidence was seen to decrease after 72 hours of use of chlorhexidine. Tooth brushing had no effect on Clinical Pulmonary Infection Score and did not in any way enhance the effects of chlorhexidine. Chlorhedexine, an antibacterial agent that is broad-spectrum in its activity has been used in healthy populations in oral rinsing. It controls dental plaque. It treats and prevents gingivitis. Bacterial resistance to this substance has not been shown in the research and the drug has few side effects. The substance can be used in reducing hospital-acquired respiratory tract infections in patients.
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