Chest
Clinical Investigations: InfectionChlorhexidine Gluconate 0.12% Oral Rinse Reduces the Incidence of Total Nosocomial Respiratory Infection and Nonprophylactic Systemic Antibiotic Use in Patients Undergoing Heart Surgery
Section snippets
MATERIALS AND METHODS
The study protocol was prospective, randomized, double-blind, placebo-controlled, and was approved by the Institutional Review Board of Lutheran Hospital of Indiana. Patients were entered into the study only after written informed consent was obtained. Concurrent participation in another research protocol was not permitted. Consecutive eligible patients who underwent coronary artery bypass grafting (CABG), valve surgery, septal surgery, cardiac tumor excision, or combined CABG valve surgery
RESULTS
Of the 353 patients who were included in the analysis, 173 patients were randomized to the CHX group and 180 to the placebo group. Table 1 illustrates that the two groups were not statistically different with regard to age, sex, type of surgery, preoperative pulmonary risk factors, preoperative WBC count, cardiopulmonary bypass time, number of bypass grafts performed, or first postoperative day albumin levels.
There was no significant difference in the number of emergency or reoperative
DISCUSSION
Our data indicate that our nosocomial infection rate is reduced by CHX treatment with individual reduction in our respiratory infection rate by 69%, but not in wound, blood, and urinary nosocomial infection rates. Furthermore, our study documents a 43% decrease in the need for nonprophylactic systemic IV antibiotics in treated patients. This finding is in accord with the conclusion of Pugin et al5 who recognized a decreased need for systemic antibiotics in mechanically ventilated ICU patients
CONCLUSION
In summary, this report shows that CHX decreases the total respiratory infection rate and the use of nonprophylactic IVs antibiotics in patients undergoing heart surgery. This results in significant cost savings for those patients who avoid treatment with additional antibiotics, and may impact favorably on mortality.
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This study was supported by a grant from the August Tomusk Foundation in Fort Wayne, Indiana.
Presented at the 22nd World Congress of the International Society of Cardiovascular Surgeons, Kyoto, Japan; September, 1995.
revision accepted November 5.