OBJECTIVES

: In this paper, we build an economic model for comparing agents used for oral hygiene (antiseptics and antibiotics) in ventilated patients versus standard care in prevention of VAP.

METHODS

: The systematic review was conducted by primary electronic database search. Searches were conducted in PubMed, Google scholar and Cochrane data bases. All articles identified by the search were initially screened for eligibility on title and abstracts. A decision analytical model was prepared for compiling the clinical and economic evidence to determine the cost effectiveness of these interventions, that is the use of agents for oral hygiene (antiseptics and antibiotics including chlorhexidine, saline, povidone) and suctioning via catheters connected to an electronic machine, VAPCare, versus the standard care. This economic analysis consists of a total of 8083 patients, control group with intubated patients who received treatment with antiseptics antibiotics (n= 4073) and case group with intubated patients who received the usual care (n= 4010). We identified costing studies for ICU and other services cost attributed to VAP and cost effectiveness studies for treatment with antiseptics and antibiotics.

RESULTS

: The average ICU length of stay (LOS) for VAP patients in the group that received treatment with antiseptics and antibiotics group was found to be 14 days, varying from 11 to 17 days, which is lower than that of the VAP patients belonging to the controlled group, that is 16 days, varying from 12 to 19 days. The incremental cost- effectiveness ratio (ICER) was also computed, and it is found that treatment with antiseptics and antibiotics and suctioning via catheters connected to VAPCare is cost effective at Rs. 9667.05/ DALY averted.

CONCLUSIONS

The results obtained showed that, among patients undertaking antiseptics, antibiotics and toothbrushing there was a significant reduction in the incidence of VAP, mortality and length of ICU stay in ICU.