The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial
Identifieur interne : 000462 ( Main/Exploration ); précédent : 000461; suivant : 000463The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial
Auteurs : Sharifah Shafinaz Binti Sharif-Abdullah [Malaisie] ; Mei Chan Chong [Malaisie] ; Surat Singh Surindar-Kaur [Malaisie] ; Shahrul Bahyah Kamaruzzaman [Malaisie] ; Kwan Hoong Ng [Malaisie]Source :
- Singapore Medical Journal [ 0037-5675 ] ; 2016.
Descripteurs français
- KwdFr :
- Anti-infectieux locaux (usage thérapeutique), Appareil respiratoire (microbiologie), Bouche édentée (), Chlorhexidine (usage thérapeutique), Femelle, Gériatrie (), Humains, Hygiène buccodentaire, Mâle, Méthode en double aveugle, Plan de recherche, Pneumopathie de déglutition (), Pneumopathie de déglutition (microbiologie), Pneumopathie infectieuse sous ventilation assistée, Sujet âgé, Sujet âgé de 80 ans ou plus, Thymol (usage thérapeutique).
- MESH :
- microbiologie : Appareil respiratoire, Pneumopathie de déglutition.
- usage thérapeutique : Anti-infectieux locaux, Chlorhexidine, Thymol.
- Bouche édentée, Femelle, Gériatrie, Humains, Hygiène buccodentaire, Mâle, Méthode en double aveugle, Plan de recherche, Pneumopathie de déglutition, Pneumopathie infectieuse sous ventilation assistée, Sujet âgé, Sujet âgé de 80 ans ou plus.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Anti-Infective Agents, Local (therapeutic use), Chlorhexidine (therapeutic use), Double-Blind Method, Female, Geriatrics (methods), Humans, Male, Mouth, Edentulous (therapy), Oral Hygiene, Pneumonia, Aspiration (microbiology), Pneumonia, Aspiration (prevention & control), Pneumonia, Ventilator-Associated, Research Design, Respiratory System (microbiology), Thymol (therapeutic use).
- MESH :
- chemical , therapeutic use : Anti-Infective Agents, Local, Chlorhexidine, Thymol.
- methods : Geriatrics.
- microbiology : Pneumonia, Aspiration, Respiratory System.
- prevention & control : Pneumonia, Aspiration.
- therapy : Mouth, Edentulous.
- Aged, Aged, 80 and over, Double-Blind Method, Female, Humans, Male, Oral Hygiene, Pneumonia, Ventilator-Associated, Research Design.
Abstract
Inadequate oral care has been implicated in the development of aspiration pneumonia in frail geriatric patients and is a major cause of mortality, due to the colonisation of microbes in vulnerable patients. This type of pneumonia has been associated with an increase in respiratory pathogens in the oral cavity. The aim of this study was to evaluate the effects of chlorhexidine compared to routine oral care in edentulous geriatric inpatients.
A double-blind, parallel-group randomised controlled trial was carried out. The intervention group received oral care with chlorhexidine 0.2%, while the control group received routine oral care with thymol. Nurses provided oral care with assigned solutions of 20 mL once daily over seven days. Oral cavity assessment using the Brief Oral Health Status Examination form was performed before each oral care procedure. Data on medication received and the subsequent development of aspiration pneumonia was recorded. An oral swab was performed on Day 7 to obtain specimens to test for colonisation.
The final sample consisted of 35 (control) and 43 (intervention) patients. Chlorhexidine was effective in reducing oral colonisation compared to routine oral care with thymol (p < 0.001). The risk of oral bacterial colonisation was nearly three times higher in the thymol group compared to the chlorhexidine group.
The use of chlorhexidine 0.2% significantly reduced oral colonisation and is recommended as an easier and more cost-effective alternative for oral hygiene.
Url:
DOI: 10.11622/smedj.2016091
PubMed: 27211885
PubMed Central: 4876416
Affiliations:
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Nursing, Faculty of Health Science, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Nursing, Faculty of Health Science, Universiti Teknologi MARA, Puncak Alam Campus, Selangor</wicri:regionArea><wicri:noRegion>Selangor</wicri:noRegion></affiliation></author><author><name sortKey="Chong, Mei Chan" sort="Chong, Mei Chan" uniqKey="Chong M" first="Mei Chan" last="Chong">Mei Chan Chong</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur</wicri:regionArea><wicri:noRegion>Kuala Lumpur</wicri:noRegion></affiliation></author><author><name sortKey="Surindar Kaur, Surat Singh" sort="Surindar Kaur, Surat Singh" uniqKey="Surindar Kaur S" first="Surat Singh" last="Surindar-Kaur">Surat Singh Surindar-Kaur</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur</wicri:regionArea><wicri:noRegion>Kuala Lumpur</wicri:noRegion></affiliation></author><author><name sortKey="Kamaruzzaman, Shahrul Bahyah" sort="Kamaruzzaman, Shahrul Bahyah" uniqKey="Kamaruzzaman S" first="Shahrul Bahyah" last="Kamaruzzaman">Shahrul Bahyah Kamaruzzaman</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur</wicri:regionArea><wicri:noRegion>Kuala Lumpur</wicri:noRegion></affiliation></author><author><name sortKey="Ng, Kwan Hoong" sort="Ng, Kwan Hoong" uniqKey="Ng K" first="Kwan Hoong" last="Ng">Kwan Hoong Ng</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Biomedical Imaging & University of Malaya Research Imaging Centre, University of Malaya, Kuala Lumpur, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Biomedical Imaging & University of Malaya Research Imaging Centre, University of Malaya, Kuala Lumpur</wicri:regionArea><wicri:noRegion>Kuala Lumpur</wicri:noRegion></affiliation></author></analytic><series><title level="j">Singapore Medical Journal</title><idno type="ISSN">0037-5675</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Anti-Infective Agents, Local (therapeutic use)</term><term>Chlorhexidine (therapeutic use)</term><term>Double-Blind Method</term><term>Female</term><term>Geriatrics (methods)</term><term>Humans</term><term>Male</term><term>Mouth, Edentulous (therapy)</term><term>Oral Hygiene</term><term>Pneumonia, Aspiration (microbiology)</term><term>Pneumonia, Aspiration (prevention & control)</term><term>Pneumonia, Ventilator-Associated</term><term>Research Design</term><term>Respiratory System (microbiology)</term><term>Thymol (therapeutic use)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anti-infectieux locaux (usage thérapeutique)</term><term>Appareil respiratoire (microbiologie)</term><term>Bouche édentée ()</term><term>Chlorhexidine (usage thérapeutique)</term><term>Femelle</term><term>Gériatrie ()</term><term>Humains</term><term>Hygiène buccodentaire</term><term>Mâle</term><term>Méthode en double aveugle</term><term>Plan de recherche</term><term>Pneumopathie de déglutition ()</term><term>Pneumopathie de déglutition (microbiologie)</term><term>Pneumopathie infectieuse sous ventilation assistée</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Thymol (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Infective Agents, Local</term><term>Chlorhexidine</term><term>Thymol</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Geriatrics</term></keywords><keywords scheme="MESH" qualifier="microbiologie" xml:lang="fr"><term>Appareil respiratoire</term><term>Pneumopathie de déglutition</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Pneumonia, Aspiration</term><term>Respiratory System</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Pneumonia, Aspiration</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Mouth, Edentulous</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anti-infectieux locaux</term><term>Chlorhexidine</term><term>Thymol</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Oral Hygiene</term><term>Pneumonia, Ventilator-Associated</term><term>Research Design</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Bouche édentée</term><term>Femelle</term><term>Gériatrie</term><term>Humains</term><term>Hygiène buccodentaire</term><term>Mâle</term><term>Méthode en double aveugle</term><term>Plan de recherche</term><term>Pneumopathie de déglutition</term><term>Pneumopathie infectieuse sous ventilation assistée</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>INTRODUCTION</title><p>Inadequate oral care has been implicated in the development of aspiration pneumonia in frail geriatric patients and is a major cause of mortality, due to the colonisation of microbes in vulnerable patients. This type of pneumonia has been associated with an increase in respiratory pathogens in the oral cavity. The aim of this study was to evaluate the effects of chlorhexidine compared to routine oral care in edentulous geriatric inpatients.</p></sec><sec id="st2"><title>METHODS</title><p>A double-blind, parallel-group randomised controlled trial was carried out. The intervention group received oral care with chlorhexidine 0.2%, while the control group received routine oral care with thymol. Nurses provided oral care with assigned solutions of 20 mL once daily over seven days. Oral cavity assessment using the Brief Oral Health Status Examination form was performed before each oral care procedure. Data on medication received and the subsequent development of aspiration pneumonia was recorded. An oral swab was performed on Day 7 to obtain specimens to test for colonisation.</p></sec><sec id="st3"><title>RESULTS</title><p>The final sample consisted of 35 (control) and 43 (intervention) patients. Chlorhexidine was effective in reducing oral colonisation compared to routine oral care with thymol (p < 0.001). The risk of oral bacterial colonisation was nearly three times higher in the thymol group compared to the chlorhexidine group.</p></sec><sec id="st4"><title>CONCLUSION</title><p>The use of chlorhexidine 0.2% significantly reduced oral colonisation and is recommended as an easier and more cost-effective alternative for oral hygiene.</p></sec></div></front></TEI><affiliations><list><country><li>Malaisie</li></country></list><tree><country name="Malaisie"><noRegion><name sortKey="Sharif Abdullah, Sharifah Shafinaz Binti" sort="Sharif Abdullah, Sharifah Shafinaz Binti" uniqKey="Sharif Abdullah S" first="Sharifah Shafinaz Binti" last="Sharif-Abdullah">Sharifah Shafinaz Binti Sharif-Abdullah</name></noRegion><name sortKey="Chong, Mei Chan" sort="Chong, Mei Chan" uniqKey="Chong M" first="Mei Chan" last="Chong">Mei Chan Chong</name><name sortKey="Kamaruzzaman, Shahrul Bahyah" sort="Kamaruzzaman, Shahrul Bahyah" uniqKey="Kamaruzzaman S" first="Shahrul Bahyah" last="Kamaruzzaman">Shahrul Bahyah Kamaruzzaman</name><name sortKey="Ng, Kwan Hoong" sort="Ng, Kwan Hoong" uniqKey="Ng K" first="Kwan Hoong" last="Ng">Kwan Hoong Ng</name><name sortKey="Sharif Abdullah, Sharifah Shafinaz Binti" sort="Sharif Abdullah, Sharifah Shafinaz Binti" uniqKey="Sharif Abdullah S" first="Sharifah Shafinaz Binti" last="Sharif-Abdullah">Sharifah Shafinaz Binti Sharif-Abdullah</name><name sortKey="Surindar Kaur, Surat Singh" sort="Surindar Kaur, Surat Singh" uniqKey="Surindar Kaur S" first="Surat Singh" last="Surindar-Kaur">Surat Singh Surindar-Kaur</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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