Does Chlorhexidine Oral Rinse Affect Outcomes in Aspiration Pneumonia?

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Researchers suggest that nursing home residents should receive more guidance in using strategies to prevent aspiration during eating and drinking.
Researchers suggest that nursing home residents should receive more guidance in using strategies to prevent aspiration during eating and drinking.

Use of chlorhexidine oral rinse solution 0.05% as an adjunctive intervention in daily oral hygiene care in nursing home residents does not reduce the incidence of aspiration pneumonia, according to a study in BMC Geriatrics.

Vanessa R. Y. Hollaar, from the Department of Neurorehabilitation, HAN University of Applied Sciences, and colleagues sought to determine whether the daily application of 0.05% chlorhexidine oral rinse solution was effective in reducing the incidence of aspiration pneumonia in nursing home residents with dysphagia. The researchers also examined potential associations regarding age, gender, dysphagia severity, care dependency, medication use, number of medical diagnoses, teeth and dental implants, wearing removable dentures, and the incidence of aspiration pneumonia.

For 1 year, patients with dysphagia in the intervention group received the usual oral hygiene care with the addition of a 0.05% chlorhexidine oral rinse solution, and participants in the control group received only oral hygiene care.

A total of 103 participants in 17 nursing homes were analyzed. The researchers found no significant difference in the incidence of pneumonia between both groups (Cox regression, hazard ratio [HR], 0.800). Cox regression analysis for Functional Oral Intake Scale (FOIS)-level showed a significant risk of pneumonia incidence (HR, 0.804).

After adjusting for Group and FOIS-level, the investigators found that that age, gender, Care-dependency Scale-score (CDS), number of diseases, medication use, number of teeth, and the presence of dental implants or removable dentures were not significantly associated with pneumonia incidence.

“Chlorhexidine oral rinse solution 0.05% as an adjunctive intervention in daily oral hygiene care was not found to reduce incidence of aspiration pneumonia,” stated the researchers. “The power was considered to be sufficient to analyze the associations between the background variables and the incidence of pneumonia in the included nursing home residents with dysphagia. Dysphagia was found to be a risk factor for aspiration pneumonia.”

Reference

Hollaar VRY, van der Putten GJ, van der Maarel-Wierink CD, Bronkhorst EM, de Swart BJM, Creugers NH. The effect of a daily application of a 0.05% chlorhexidine oral rinse solution on the incidence of aspiration pneumonia in nursing home residents: a multicenter study. BMC Geriatr. 2017;17(1):128. doi: 10.1186/s12877-017-0519-z

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