Comparison of antibacterial effects of oral rinses chlorhexidine and herbal mouth wash in patients admitted to intensive care unit

Abstract

Background and purpose: Mouthwashes decrease the risk of VAP by reducing the number of microorganisms and their transmission and colonization in the lung. Among the oral rinses, chlorhexidine is considered as the gold standard but it has a variety of complications. The purpose of this study was to determine and compare anti-bacterial effects of the chlorhexidine gluconate and herbal mouthwashes in intensive care unit patients.

Materials and methods: In this double blind randomized clinical trial, 60 patients who were admitted in ICU were divided into two equal 30 persons groups. In the first group Chlorhexidine gluconate 2 % mouthwash and in the second group herbal mouth wash was used. Just before and again after 6 min of oral rinsing, salivary samples were obtained without any stimulation in order to culture Staphylococcus aureus and Streptococcus pneumoniae. The data were processed in SPSS16 software and were analyzed by appropriate statistical tests.

Results: Matrica® and chlorhexidine mouthwashes have significant antibacterial effects against Streptococcus pneumoniae and Staphylococcus aureus. Decreasing of the number of bacteria in samples after oral rinsing was significant in both groups (p <0.001) but chlorhexidine was significantly more effective than herbal mouth wash in reducing the number of colonies (p < 0.001).

Conclusion: The herbal mouth wash has significant antibacterial effects against Staphylococcus aureus and Streptococcus pneumoniae, but its efficacy is less than chlorhexidine, so after further investigation, it would be considered as an alternative to chlorhexidine in ICUs (Tab. 3, Ref. 33).