To: The use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia - Critical Care Science (CCS)

To: The use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia |

To the Editor

An article titled “The use of 2% chlorhexidine gel and tooth brushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia” was published in Rev Bras Ter Intensiva (2012; 24(4):369-74).⁽⁾ While the researchers terminated the study due to the futility of the applied method, the unrealistic results of the study inspired us to write this letter. The mentioned paper had the following fundamental scientific and technical problems:

The destructive effects of chlorhexidine on the oral mucosa might have been responsible for the higher infection rates in the intervention group compared to the placebo group. In other words, the gel might have facilitated bacterial growth by destroying one of the most important defensive barriers. Furthermore, reactions between chlorhexidine and the gel components might have accelerated bacterial growth by providing nutrition.

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