Table 1.

 Characteristics of included trials

Study	Population	Intervention	Comparison	Outcomes	Follow-up	Funding
Bergmans 2001w1	Mixed	Orabase with gentamicin, colistin, and vancomycin, 4 times daily until extubation, death, limited to 21 days	Control A, placebo in intensive care unit with patients receiving topical antimicrobial prophylaxis; control B, placebo in intensive care unit with no topical antimicrobial prophylaxis	Ventilator associated pneumonia: clinical, radiological, and bacteriological investigations, including quantitative culture of bronchoalveolar lavage fluid or protected specimen brush. Mortality in hospital	Until extubation or death	Local and industry
De Riso 1996w4	Cardiothoracic (open heart surgery)	Chlorhexidine 0.12% 15 ml preoperatively and twice daily postoperatively until discharge from intensive care or death	Placebo	Ventilator associated pneumonia: Centers for Disease Control and Prevention criteria.‡ Mortality in hospital	Until discharge from intensive care unit or death	Local
Fourrier 2000w5*	Medical or surgical	Chlorhexidine 0.2% gel three times daily during stay in intensive care unit until 28 days, discharge from intensive care, or death	Standard treatment	Ventilator associated pneumonia: clinical, radiological, and bacteriological investigations and quantitative culture of tracheal aspirate or bronchoalveolar lavage fluid, or both. Mortality in intensive care unit	Until discharge from intensive care unit or death	Local
Fourrier 2005w6*†	60% medical, 40% surgical	Chlorhexidine 0.2% gel three times daily during stay in intensive care unit until 28 days	Placebo	Ventilator associated pneumonia: clinical, radiological, and bacteriological investigations and quantitative culture of tracheal aspirate or bronchoalveolar lavage fluid, or both. Mortality in intensive care unit by day 28	Until 28 days in intensive care, discharge from intensive care unit, or death	Local, and industry provided study drug
Koeman 2006w7*	Mixed	Treatment A, chlorhexidine 2% in white petroleum vehicle four times daily until diagnosis of ventilator associated pneumonia, death, or extubation; treatment B, chlorhexidine 2% and colistin four times daily	Placebo	Ventilator associated pneumonia: clinical, radiological, and bacteriological investigations and semiquantitative culture of tracheal aspirates. Independent adjudication committee determined if patients had ventilator associated pneumonia. Mortality in intensive care unit	Until extubation, discharge from intensive care unit, or death	Local
Kollef 2006w2†	83% non-trauma, 27% trauma	Iseganan 3 ml (9 mg) six times daily until 14 days. Treatment discontinued if patient developed ventilator associated pneumonia or was extubated	Placebo	Ventilator associated pneumonia: clinical, radiological, and bacteriological investigations, including quantitative culture of bronchoalveolar lavage fluid or non-directed bronchoalveolar lavage fluid. Mortality in intensive care unit by day 14	Until 21 days or death	Industry
Laggner 1994w3	General intensive care	Gentamicin gel four times daily until extubation. All received oral amphotericin B and oral disinfection with phenylhydragyrum boricum and hexetidine	Placebo	Ventilator associated pneumonia: clinical and radiological investigations and positive culture of tracheal secretions. Mortality in intensive care unit	Until extubation	Not reported
MacNaughton 2004w11*	Medical or surgical	Chlorhexidine 0.2% oral rinse twice daily until extubation or death	Placebo	Ventilator associated pneumonia: leucocytosis and pyrexia >38°C; deterioration in arterial blood gases; chest signs; new consolidation on chest radiography; and significant semiquantitative culture of non-directed bronchoalveolar lavage fluid. Definite pneumonia 4/4 if met all four criteria. Mortality in intensive care unit	Not available	Local
Rios 2005w10*	Medical or surgical (including trauma)	Polymyxin B and gentamicin gel three times daily until 24 hours after extubation	Placebo	Ventilator associated pneumonia: clinical, radiological, and bacteriological, including positive quantitative culture of tracheal secretions. Mortality in intensive care unit	Until 28 days after ventilator associated pneumonia diagnosis or discharge from intensive care unit, or hospital discharge	Local
Segers 2005w9*	Cardiothoracic	Chlorhexidine 0.12%, nasal ointment, and 10 ml oropharynx rinse four times daily on allocation and admission to hospital until extubation or removal of nasogastric tube	Placebo	Ventilator associated pneumonia: Centers for Disease Control and Prevention criteria (no microbiological confirmation required). Mortality in hospital	Until 48 hours after discharge	Local
Seguin 2006w8*	Surgical (severe closed head trauma)	Povidone iodine 10% 20 ml reconstituted to 60 ml with sterile water to nasopharynx and oropharynx six times daily until extubation	Control A, saline rinse 60 ml; control B, standard treatment	Ventilator associated pneumonia: clinical, radiological, and bacteriological investigations including positive quantitative culture of bronchoalveolar lavage fluid or non-directed bronchoalveolar lavage fluid. Mortality in intensive care unit	Until discharge from intensive care unit	Not funded

*Published and unpublished data.

†Trial stopped early.

‡Unclear if clinically defined ventilator associated pneumonia or microbiology confirmed ventilator associated pneumonia.