Document Detail

Reduction of potential respiratory pathogens by oral hygienic treatment in patients undergoing endotracheal anesthesia.
MedLine Citation:
PMID:  12903918     Owner:  NLM     Status:  MEDLINE    
PURPOSE: This study was conducted to evaluate the usefulness of mechanical and chemical prophylactic oral cleansing treatments for reducing potential respiratory pathogens existing in the oral cavity. METHODS: Thirty-two patients scheduled to undergo oral and maxillofacial surgery that required endotracheal anesthesia were randomly allocated to one of the two groups, the oral cleansing group (n = 16) or the noncleansing group (n = 16). Culture and polymerase chain reaction (PCR) methods were used to detect and enumerate pathogens. Oral cleansing was carried out with an electric toothbrush capable of automatically supplying and aspirating povidone-iodine solution before surgery, followed by rinsing twice a day after surgery. Cephazolin (3 g x day(-1)) was given to all patients for 5 days after surgery. RESULTS: The PCR detection rates of Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Porphyromonas gingivalis in gargle samples before treatment were 87.5%, 68.8%, 53.1%, and 40.6%, respectively. Oral cleansing reduced the detection rates and numbers of methicillin-sensitive Staphylococcus species, S. pneumoniae, and H. influenzae. In contrast, there was no significant reduction of methicillin-resistant Staphylococcus species, S. pneumoniae, H. influenzae, or P. aeruginosa in subjects who underwent systemic cephazolin administration without oral cleansing. CONCLUSION: The combination of mechanical and chemical oral cleansing resulted in a significant reduction of potential respiratory pathogens in the oral cavity.
Minori Okuda; Yuzuru Kaneko; Tatsuya Ichinohe; Kazuyuki Ishihara; Katsuji Okuda
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of anesthesia     Volume:  17     ISSN:  0913-8668     ISO Abbreviation:  J Anesth     Publication Date:  2003  
Date Detail:
Created Date:  2003-08-07     Completed Date:  2003-08-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  84-91     Citation Subset:  IM    
Oral Health Science Center and Department of Dental Anesthesiology, Tokyo Dental College, 1-2-2 Masago, Chiba 261-8502, Japan.
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MeSH Terms
Anti-Infective Agents, Local / administration & dosage
Antibiotic Prophylaxis
Bacteria / drug effects,  isolation & purification*
Colony Count, Microbial
Intubation, Intratracheal*
Middle Aged
Mouth / microbiology*
Oral Hygiene*
Postoperative Care
Povidone-Iodine / administration & dosage
Preoperative Care
Respiratory Tract Infections / prevention & control*
Surgery, Oral
Reg. No./Substance:
0/Anti-Infective Agents, Local; 0/Mouthwashes; 25655-41-8/Povidone-Iodine

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