Two recent meta-analyses regarding the efficacy of topical chlorhexidine for prevention of VAP concluded that oral decontamination of mechanically ventilated adults using antiseptics is associated with a lower risk of VAP (relative risk and 95% confidence interval 0.74 [0.56-0.96] 15 and 0.61 [0.45-0.82],(16) respectively). Limitations clearly have been delineated in these studies, including different patient populations studied (cardiac, surgical and medical), duration of mechanical ventilation, concentration of CHX used, timing and method for CHX application, and lack of standardized definition of VAP.(17)