AbstractBackgroundTracheostomy‐tube change protocols are implemented primarily due to concern regarding infections. Currently changes vary from within 4 weeks post‐insertion to 3 monthly thereafter. However, currently no evidence‐based guidelines exist to justify these protocols. This study aims to assess the colonization of tracheostomy‐tubes associated with the frequency of changes.MethodsA prospective cohort study over 18‐months of adult tracheostomy patients at a single institution (inpatient/outpatients). Patients were grouped based on whether tubes were changed at ≤4 weeks or >4 weeks and microbiology swabs sent for microscopy, culture and sensitivities.ResultsA total of 65 patients were enrolled. No statistically significant difference in colonization in patients undergoing tube changes more than every 4 weeks to those less than every 4 weeks was found (56.2% versus 57.1%, χ2 = 0.004, P = 0.95).ConclusionThe timing of tracheostomy‐tube changes may not affect colonization and infection rates. Routine changes for the purpose of reducing infection risk may not be needed unless clinically indicated.