To the Editor In their systematic review and meta-analysis, Klompas et al1 assessed oral care with chlorhexidine gluconate in mechanically ventilated patients. The authors compared studies that included cardiac or non–cardiac surgery patients, concluding that there was only evidence of benefit, ie, less pneumonia, in the cardiac surgery population. There was also a suggestion that chlorhexidine might even be harmful in the non–cardiac surgery population, with the authors concluding that “[t]he lack of clear evidence that adding chlorhexidine to routine oral care benefits non–cardiac surgery patients should prompt reexamination of hospital policies mandating its use.”1(p758) This conclusion might be premature when one considers the mechanism of action of chlorhexidine.
Sands KM, Twigg JA, Wise MP. Oral Hygiene With Chlorhexidine in Critically Ill Patients. JAMA Intern Med. 2015;175(2):316. doi:10.1001/jamainternmed.2014.7174