Effectiveness of oral chlorhexidine for the prevention of nosocomial pneumonia and ventilator-associated pneumonia in intensive care units: Overview of systematic reviews.

OBJECTIVE: To summarize evidence regarding the effectiveness of using chlorhexidine for oral healthcare on patients in the intensive care unit for the prevention of nosocomial pneumonia and ventilator-associated pneumonia. METHODS: This overview of systematic reviews was developed using articles found in PUBMED, Cochrane Library, LILACS, CRD, CINHAL, manual search and grey literature. RESULTS: Of the total 16 systematic reviews, 14 included meta-analysis. Most of them were classified with high methodological quality. In seven systematic reviews, chlorhexidine was effective for prevention of nosocomial pneumonia and ventilator-associated pneumonia in adult population in cardiothoracic intensive care unit. The effectiveness was contradictory with other population patients in intensive care units. CONCLUSION: Chlorhexidine has proven to be effective for the prevention of NP among adult populations in cardiothoracic ICU. In ICUs with patients who have varied clinical-surgical conditions, the effectiveness of chlorhexidine for the prevention of PN and VAP was inconclusive.

Toxic concentrations of metronidazole to Microcystis protocystis / Concentrações tóxicas de metronidazol para Microcystis protocystis

Antimicrobials are among the most commonly used drugs and have become a class of contaminants with great environmental importance. Metronidazole is an antimicrobial used for the therapeutic management of several human diseases. The toxicity of antimicrobials on aquatic species may affect sensitive microorganisms and reduce metabolic processes. Cyanobacteria is a group of organisms that are of great ecological importance in aquatic environments. Studies indicate that cyanobacteria are very sensitive to some antimicrobials. Therefore, it is necessary to evaluate the effects of metronidazole contamination on phytoplankton. The aim of this study was to investigate the effects of metronidazole on the growth of the cyanobacterium Microcystis protocystis and to evaluate the stability of this antimicrobial agent in the culture medium over a period of 96 hours. M. protocystis was resistant to growth inhibition by metronidazole. The EC50 of this antimicrobial for M. protocystis was 117.3 mg L–1. Under the growth inhibition test conditions, neither a significant change in the MNZ concentration nor the presence of drug metabolites or degradation products was observed. These results indicate low cellular uptake of the antimicrobial agent and its persistence in the culture medium.

Antimicrobianos estão entre os fármacos mais usados e tem se tornado uma classe emergente de contaminantes com grande importância ambiental. A toxicidade dos antimicrobianos sobre as espécies aquáticas podem afetar microrganismos sensíveis e reduzir seus processos metabólicos. O Metronidazol é um antimicrobiano usado para o manejo terapêutico de várias doenças humanas. Cyanobacteria é um grupo de organismos de grande importância ecológica no ambiente aquático. O estudo visou investigar os efeitos do metronidazol- MNZ sobre o crescimento da cianobactéria Microcystis protocystis e avaliar a persistência do antimicrobiano no meio de cultivo durante 96h. A M. protocystis mostrou-se resistente à inibição de crescimento pelo MNZ. A EC50% do MNZ para a espécie foi 117,3 mg L–1. Nas condições do teste de inibição de crescimento não foi observada variação significativa da concentração de MNZ nem a presença de metabólitos ou produtos de degradação do fármaco, indicando baixa captação celular do antimicrobiano e sua persistência no meio de cultivo.

Toxic concentrations of metronidazole to Microcystis protocystis

Antimicrobials are among the most commonly used drugs and have become a class of contaminants with great environmental importance. Metronidazole is an antimicrobial used for the therapeutic management of several human diseases. The toxicity of antimicrobials on aquatic species may affect sensitive microorganisms and reduce metabolic processes. Cyanobacteria is a group of organisms that are of great ecological importance in aquatic environments. Studies indicate that cyanobacteria are very sensitive to some antimicrobials. Therefore, it is necessary to evaluate the effects of metronidazole contamination on phytoplankton. The aim of this study was to investigate the effects of metronidazole on the growth of the cyanobacterium Microcystis protocystis and to evaluate the stability of this antimicrobial agent in the culture medium over a period of 96 hours. M. protocystis was resistant to growth inhibition by metronidazole. The EC50 of this antimicrobial for M. protocystis was 117.3 mg L1. Under the growth inhibition test conditions, neither a significant change in the MNZ concentration nor the presence of drug metabolites or degradation products was observed. These results indicate low cellular uptake of the antimicrobial agent and its persistence in the culture medium.

Antimicrobianos estão entre os fármacos mais usados e tem se tornado uma classe emergente de contaminantes com grande importância ambiental. A toxicidade dos antimicrobianos sobre as espécies aquáticas podem afetar microrganismos sensíveis e reduzir seus processos metabólicos. O Metronidazol é um antimicrobiano usado para o manejo terapêutico de várias doenças humanas. Cyanobacteria é um grupo de organismos de grande importância ecológica no ambiente aquático. O estudo visou investigar os efeitos do metronidazol- MNZ sobre o crescimento da cianobactéria Microcystis protocystis e avaliar a persistência do antimicrobiano no meio de cultivo durante 96h. A M. protocystis mostrou-se resistente à inibição de crescimento pelo MNZ. A EC50% do MNZ para a espécie foi 117,3 mg L1. Nas condições do teste de inibição de crescimento não foi observada variação significativa da concentração de MNZ nem a presença de metabólitos ou produtos de degradação do fármaco, indicando baixa captação celular do antimicrobiano e sua persistência no meio de cultivo.