The antiseptic, chlorhexidine, is often swabbed into the mouths of critically ill patients on breathing machines to prevent pneumonia associated with ventilators.  Chlorhexidine, the most commonly used antiseptic for this application, is affordable, effective, and readily available but researchers behind a recent study suggest friendly microorganisms may work better.

Ventilator-associated pneumonia occurs when a patient on a breathing machine inhales into the lungs bacteria from his or her own mouth, throat, and breathing tube.  Once colonized in the lungs, pneumonia develops.

Chlorhexidine effectively reduces the risk of developing pneumonia while on a ventilator but the antiseptic isn’t the ideal solution for all patients, as some individuals are allergic to it.  Antiseptics, like all drugs, come with the potential for adverse side effects, too, that may preclude its use in particular patients.  Another concern with antiseptics is the risk that the bacteria that cause pneumonia will eventually develop a resistance to it.

At University Hospital in Lund, Sweden, Bengt Klarin and his colleagues tested chlorhexidine against the bacterium, Lactobacillus plantarum 299, a probiotic found in saliva and fermented food products, such as sauerkraut and pickles.  Probiotic is a term used to designate naturally occurring microorganisms that produce beneficial results to humans.

The Klarin study found that critically ill patients on ventilators were equally protected against pneumonia when either the probiotic or the antiseptic were used.  Because probiotics are products of nature, they are thought to be safer than antiseptics and they work round the clock, as they themselves colonize the patient’s airways.  Antiseptics work only a few hours after application.

The Swedish team, which worked with just 50 study subjects, has expressed the hope of further, larger studies to thoroughly document the beneficial effect of using probiotics in lieu of antiseptics to ward off ventilator-associate pneumonia.