Harrison G. Weed, MD
In older persons in hospitals and nursing homes, does enhanced oral hygiene prevent respiratory infection?
Included studies evaluated the effect of enhanced oral hygiene care or frequent professional oral care on respiratory infection in older persons in hospitals or nursing homes. Outcomes were respiratory infection, pneumonia, and death from pneumonia.
MEDLINE, Cochrane Central Register of Controlled Trials, and National Health Service Economic Evaluation Database (1996 to Nov 2007); and reference lists were searched for randomized controlled trials (RCTs) published in English, German, Dutch, or a Nordic language between 1996 and 2007. Studies involving patients with mechanical ventilation or tube-feeding were excluded. 3 RCTs (n = 807) met the selection criteria. 1 placebo-controlled trial was double-blinded. An additional crossover trial (n = 46) of uncertain randomization status did not provide useful data.
Meta-analysis was not done because of differences in interventions and outcomes. The Table shows the results of individual trials.
In older persons in hospitals and nursing homes, enhanced oral hygiene prevents respiratory infection and death from pneumonia.
Enhanced oral hygiene vs placebo or usual care (control) to prevent respiratory infection in older persons in hospitals and nursing homes*
*Abbreviations defined in Glossary. RRR, NNT, and CI calculated from data in article.
Weed HG. Review: Enhanced oral hygiene prevents respiratory infection in older persons in hospitals and nursing homes. Ann Intern Med. ;150:JC3–7. doi: 10.7326/0003-4819-150-6-200903170-02007
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Published: Ann Intern Med. 2009;150(6):JC3-7.
Geriatric Medicine, Infectious Disease.
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