Comparing the effect of echinacea and chlorhexidine mouthwash on the microbial flora of intubated patients admitted to the intensive care unit

Abstract

Background:Providing intubated patients admitted to the intensive care units with oral healthcare is one of the main tasks of nurses in order to prevent Ventilator-Associated Pneumonia (VAP). This study aimed at comparing the effects of two mouthwash solutions (echinacea and chlorhexidine) on the oral microbial flora of patients hospitalized in the intensive care units.Materials and Methods:In this clinical trial, 70 patients aged between18 and 65 years undergoing tracheal intubation through the mouth in three hospitals in Arak, were selected using simple random sampling and were randomly divided into two groups: the intervention group and the control group. The oral health checklist was used to collect the data (before and after the intervention). The samples were obtained from the orally intubated patients and were then cultured in selective media. Afterwards, the aerobic microbial growth was investigated in all culture media. The data were analyzed using SPSS software.Results:The microbial flora in the echinacea group significantly decreased after the intervention (p < 0.0001) and it was also the case withmicrobial flora of the patients in the chlorhexidine group (p < 0.001). After 4 days, the oral microbial flora of the patients in the intervention group was lower than that of the patients in the control group (p < 0.001).Conclusions:The results showed that the echinacea solution was more effective in decreasing the oral microbial flora of patients in the intensive care unit. Given the benefits of the components of the herb Echinacea, it can be suggested as a viable alternative to chlorhexidine.

Effects of a Comprehensive Oral Care Program and a Combined Toothbrush and Mouthwash Program with 0.2% Chlorhexidine on Oral Health in Mechanically Ventilated Intubated Patients: A Clinical Trial

“…Thus, a score of 5 means no disorder, 6 -10 means a mild disorder, 11 -15 means a moderate disorder, and 16 -20 means a severe disorder. Safarabadi et al (9) confirmed the scale's validity and reliability using the test-retest method with a Pearson correlation coefficient of 0.92. In the present study, the scale's reliability was confirmed using the inter-rater reliability method with a coefficient of 0.93.…”

“…It is generally accepted that "good and frequent oral care" is more important for these patients and can be provided by several separate or combined methods such as mouthwash, gel use, toothbrush, and secretion suction (8). Safarabadi et al (9) quotes Grap and Munro that oral health and care should be considered as one of the most significant components of nursing care.…”

Oral status and affecting factors in Iranian ICU patients: a cross-sectional study

“…Figure 1 shows the components of BOAS, which is brought from the study of Nguh (2016) [12]. Safarabadi et al (2017) confirmed the validity and reliability of the BOAS tool, in which content validity was supported by three anesthesiologists, two neurosurgeons, and five expert nurses working in ICUs. The testretest method has been used to determine its reliability by evaluating twenty ICU patients by two observers separately, and a correlation coefficient of 0.92 was obtained [13].…”

Antiviral mouthwashes: possible benefit for COVID-19 with evidence-based approach

“…Results of a study of hospitalized patients have also shown that pathogenic microorganisms are present in patients’ mouths from day one and show an increasing trend during hospitalization [ 35 ]. Therefore, it seems that the use of CHX in COVID-19 patients who have altered oral flora, whether in a hospital or non-hospital setting is an important procedure to improve the symptoms in these patients [ 25 , 36 ].…”