Efficacy of salvadora presica (Miswak) against chlorhexidine mouthwash on oral Gram negative bacteria in mechanical ventilation patients

The composition of the oral and pharyngeal microbial flora of patients admitted to the intensive care unit within 48 hours after admission easily changes from gram-positive streptococci to dominant gram-negative pathogens and this can increase the incidence of infection and death of patients. Therefore, the aim of this study was to evaluate the efficacy of salvadora presica (Miswak) against chlorhexidine on Gram-negative oral bacteria.

In this clinical trial study, patients were selected by available sampling and divided into two groups by simple random sampling. Patients in the intervention group received oral care with a Miswak and the control group received chlorhexidine mouthwash. Colony status of Gram-negative bacteria in patients' mouths before the intervention and finally on the fifth day of the study were evaluated by sampling oral secretions and the obtained information were compared using Fisher's exact test.

The mean and standard deviation of age were 34.2±13.6 years which did not differ significantly (P=0.72). There was no statistically significant difference between the two groups regarding gender (P=0.28). As the main target, no significant difference was observed between the two groups before treatment (P=0.16). However, after treatment the two groups had a statistically significant difference in the Gram-negative bacteria colonies (P<0.0001).

Salvadora presica (Miswak) had more effect on oral bacteria than chlorhexidine.