To resolve this dilemma, Listerine™ was used at 50% strength to obtain antimicrobial effects while minimizing adverse effects by diluting the alcohol. Because existing care routines allowed the resident to be monitored for adverse side effects, substituting half-strength Listerine for chlorhexidine could be implemented in a safe manner. This is a good example of how guideline recommendations may require some modification based on the individual resident situation and clinical judgment.