Comparing the Effectiveness of Miswak+Aloe Vera Mouthwash with Chlorhexidine Mouthwash on the Prevention of Ventilator-Induced Pneumonia: A Randomized Clinical Trial

Background: Ventilator-associated pneumonia (VAP) is a common nosocomial infection in patients hospitalized in the intensive care unit (ICU), which can lead to a long stay in the ICU, increased costs, and mortality. Method: This study was a randomized clinical trial conducted on 70 patients with a tracheal tube and hospitalized in the ICU. The participants were selected using targeted samrandomly divided into two groups: miswak+aloe vera mouthwash and chlorhexidine gluconate (CHG) mouthwash. For patients in the intervention group, mouthwash containing a combination of the blue extract of miswak with a concentration of 10% and aloe vera with a concentration of 94% manufactured by Barij Essans Kashan Company was used for five days twice daily. For patients in the control group, a 0.2% CHG mouthwash made by Shahr Daru Company was used for five days twice daily. On the fifth day, VAP was evaluated based on the Modified Pulmonary Infection Clinical Criteria Checklist (MCPIS), and the data were analyzed using Chi-squared, independent t, Mann-Whitney U, and McNemar tests in SPSS software. Results: There was no significant relationship between demographic indicators and risk factors of both nodes (P>0.05). The results of the study showed that the prevalence of late-onset VAP was 22.9% (n=8) in the mouthwash group containing miswak+aloe vera and 14% (n=14) in the CHG group, although this decrease was not statistically significant (P=0.13). Conclusion: Compared to the CHG mouthwash, miswak+aloe vera mouthwash has a greater effect on reducing the prevalence of chronic VAP in patients with tracheal tubes.