Preventing lower airway colonization and infection in mechanically ventilated patients.

We report the results of a prophylactic regime designed to prevent endogenous colonization and infection of the lower airways by Gram-negative bacilli. The 27 study patients spent an average of 30 days (range 11 to 84) in the respiratory ICU, during which time they were on mechanical ventilation. Within 3 days of application of 2% polymyxin E and tobramycin in an adhesive paste to the buccal mucosa, the oral cavity of each patient was free of Gram-negative bacilli, and subsequently, no patient developed tracheal aspirates containing Gram-negative bacilli, and no study patient developed nosocomial pneumonia.