SynthesisBMJ (Clinical research ed.)2007
Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis.
Synthesis in BMJ (Clinical research ed.), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01498601 (Improving Oral Care to Reduce Hospital Acquired Pneumonia), which is not on this map. Cited by 80 papers, 14 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Oral Care to Reduce Hospital Acquired Pneumonia (HAP) in the Acute, Non-Intubated, Care Dependent, Neurologically Impaired Adult Patient Population
Who cites it
80 citing papers in PubMed, 14 syntheses or guidelines pooled it, 407 citations in OpenAlex.
- Multivariate meta-analysis of critical care meta-analyses: a meta-epidemiological study.BMC medical research methodology · 2021Pooled it
- Interventions for improving oral health in people after stroke.The Cochrane database of systematic reviews · 2020Pooled it
- Incidences of Pseudomonas aeruginosa-Associated Ventilator-Associated Pneumonia within Studies of Respiratory Tract Applications of Polymyxin: Testing the Stoutenbeek Concurrency Postulates.Antimicrobial agents and chemotherapy · 2018Pooled it
- Impact of selective digestive decontamination on respiratory tract Candida among patients with suspected ventilator-associated pneumonia. A meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Pooled it
- ICU-acquired candidemia within selective digestive decontamination studies: a meta-analysis.Intensive care medicine · 2015Pooled it
- Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2014Pooled it
- The perfidious effect of topical placebo: calibration of Staphylococcus aureus ventilator-associated pneumonia incidence within selective digestive decontamination studies versus the broader evidence base.Antimicrobial agents and chemotherapy · 2013Pooled it
- Impact of oral care with versus without toothbrushing on the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials.Critical care (London, England) · 2012Pooled it
- Prevention of ventilator-associated pneumonia, mortality and all intensive care unit acquired infections by topically applied antimicrobial or antiseptic agents: a meta-analysis of randomized controlled trials in intensive care units.Critical care (London, England) · 2011Pooled it
- Guideline
- Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI)).German medical science : GMS e-journal · 2010Guideline
- Ventilator-associated pneumonia: current status and future recommendations.Journal of clinical monitoring and computing · 2010Pooled it
- Guideline
- Oral care and nosocomial pneumonia: a systematic review.Einstein (Sao Paulo, Brazil)Pooled it
- Evidence-Based Mouth and Oral Health Individualised Treatment Plan in Adults With Acquired Brain Injury: A Cluster Nonrandomized Controlled Trial.Journal of oral rehabilitation · 2026Trial
- Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial.International dental journal · 2018Trial
- Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient? A multicentre, prospective, randomised controlled open trial.Critical care (London, England) · 2018Trial
- Ventilator-associated pneumonia with or without toothbrushing: a randomized controlled trial.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2012Trial
- The impact of oral health and 0.2% chlorhexidine oral gel on the prevalence of nosocomial infections in surgical intensive-care patients: a randomized placebo-controlled study.Wiener klinische Wochenschrift · 2010Trial
- A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients.Critical care (London, England) · 2009Trial
20 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effect of oral decontamination on the incidence of ventilator associated pneumonia and mortality in mechanically ventilated adults.
designSystematic review and meta-analysis. DATA SOURCES: Medline, Embase, CINAHL, the Cochrane Library, trials registers, reference lists, conference proceedings, and investigators in the specialty. REVIEW
methodsTwo independent reviewers screened studies for inclusion, assessed trial quality, and extracted data. Eligible trials were randomised controlled trials enrolling mechanically ventilated adults that compared the effects of daily oral application of antibiotics or antiseptics with no prophylaxis.
results11 trials totalling 3242 patients met the inclusion criteria. Among four trials with 1098 patients, oral application of antibiotics did not significantly reduce the incidence of ventilator associated pneumonia (relative risk 0.69, 95% confidence interval 0.41 to 1.18). In seven trials with 2144 patients, however, oral application of antiseptics significantly reduced the incidence of ventilator associated pneumonia (0.56, 0.39 to 0.81). When the results of the 11 trials were pooled, rates of ventilator associated pneumonia were lower among patients receiving either method of oral decontamination (0.61, 0.45 to 0.82). Mortality was not influenced by prophylaxis with either antibiotics (0.94, 0.73 to 1.21) or antiseptics (0.96, 0.69 to 1.33) nor was duration of mechanical ventilation or stay in the intensive care unit.
conclusionsOral decontamination of mechanically ventilated adults using antiseptics is associated with a lower risk of ventilator associated pneumonia. Neither antiseptic nor antibiotic oral decontamination reduced mortality or duration of mechanical ventilation or stay in the intensive care unit.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.