What do systematic reviews say?

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs placebo or usual care

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care probably leads to lower incidence of VAP compared with placebo or usual care (moderate certainty).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  RR 0.67 [0.47, 0.97]
  13 studies · 1206 participants
  Moderate

Povidone iodine rinse vs usual or supportive care

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Povidone iodine versus usual care (Seguin 2006, 67 participants): a reduction in VAP was found; single study, not replicated, interpret with caution.
  1 study · 67 participants
  GRADE not reported

Saline rinse plus swab vs Saline-soaked swab

Saline rinse plus swab led to lower incidence of VAP compared with saline-soaked swab alone (usual care); GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  RR 0.41 [0.23, 0.72]
  2 studies · 153 participants
  GRADE not reported

Saline rinse vs usual or supportive care

Saline rinse led to lower incidence of VAP compared with usual care (no rinse); GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  RR 0.60 [0.39, 0.91]
  2 studies · 324 participants
  GRADE not reported