Efficacy of Chlorhexidine Versus Listerine Perioperative Mouthwash in Preventing Ventilator-Acquired Pneumonia: An Integrative Review

Abstract

<p><em>Objective: </em>To compare the safety and efficacy of chlorhexidine versus Listerine in perioperative and intensive care settings in preventing ventilator-acquired pneumonia (VAP).</p> <p><em>Methods: </em>An integrative review using a keyword search was conducted in Cochrane, Cinahl, and Google Scholar databases. Data was collected regarding the efficacy of chlorhexidine and Listerine in preventing ventilator-acquired pneumonia, safety and side effect profiles, and <em>in vivo</em><em>in vitro </em> secondary outcome measures. </p> <p><em>Results:</em> Chlorhexidine demonstrates superiority to Listerine in reducing ventilator-acquired pneumonia. Secondary <em>in vivo </em>tests including plaque and gingivitis reduction, and <em>in vitro </em>tests measuring the effect on bacterial loads, also favors chlorhexidine over Listerine. Chlorhexidine has shown to have significantly more side effects compared to Listerine.</p> <p><em>Conclusions: </em>Chlorhexidine is justifiably used in preventing ventilator-acquired pneumonia over Listerine. There is a gap in knowledge due to the lack of randomized-controlled trials utilizing Listerine in VAP bundles. Future research should focus on finding an alternative mouthwash to chlorhexidine that is equally effective at reducing VAP incidence, but lacks chlorhexidine’s undesirable side effect profile.</p>