Impact of selective decontamination of the digestive tract on multiple organ dysfunction syndrome: Systematic review of randomized controlled trials*

Silvestri, Luciano; Saene, H. K. F. van; Zandstra, D. F.; Marshall, John C.; Gregori, Darío; Gullo, Antonino

doi:10.1097/ccm.0b013e3181d9db8c

Cited by 70 publications

(41 citation statements)

References 45 publications

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“…Indeed, past studies have shown that selective gut decontamination may reduce severe infections, incidence of multiple-organ dysfunction syndrome, and may lower the risk of acute GVHD. [64][65][66][67][68][69][70] Interestingly, both of our two prophylactic protocols seemed to be equally effective in terms of reducing BSIs. However, an incidental, but possibly important finding was the increase in resistant GNB to potent antibiotics that are commonly used in the treatment of febrile neutropenia.…”

Section: Discussionmentioning

confidence: 99%

Impact of bloodstream infections on outcome and the influence of prophylactic oral antibiotic regimens in allogeneic hematopoietic SCT recipients

Liu

Lai

Huang

et al. 2010

Bone Marrow Transplant

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This study aimed to determine the impact of blood stream infections (BSIs) on outcome of allogeneic hematopoietic SCT (HSCT), and to examine the influence of old (nonlevofloxacin-containing) and new (levofloxacin-based) prophylactic antibiotic protocols on the pattern of BSIs. We retrospectively enrolled 246 allogeneic HSCT recipients between January 1999 and June 2006, dividing patients into BSI (within 6 months post-HSCT, n ¼ 61) and non-BSI groups (n ¼ 185). We found that Gramnegative bacteria (GNB) predominated BSI pathogens (54%). Multivariate analyses showed that patients with a BSI, compared with those without, had a significantly greater 6-month mortality (hazard ratio, 1.75; 95% confidence interval, 1.09-2.82; P ¼ 0.021) and a significantly increased length of hospital (LOH) stay (70.8 vs 55.2 days, P ¼ 0.014). Moreover, recipients of old and new protocols did not have a significantly different 6-month mortality and time-to-occurrence of BSIs. However, there were significantly more resistant GNB to third-generation cephalosporins and carbapenem in recipients of levofloxacin-based prophylaxis. Our data suggest that BSIs occur substantially and impact negatively on the outcome and LOH stay after allogeneic HSCT despite antibiotic prophylaxis. Levofloxacin-based prophylaxis, albeit providing similar efficacy to non-levofloxacin-containing regimens, may be associated with increased antimicrobial resistance.

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Section: Discussionmentioning

confidence: 99%

Impact of bloodstream infections on outcome and the influence of prophylactic oral antibiotic regimens in allogeneic hematopoietic SCT recipients

Liu

Lai

Huang

et al. 2010

Bone Marrow Transplant

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“…, Sadfar et al (10) and Silvestri et al (16) showed an impact on mortality. However, due to small sample size, the differences were not significant.…”

Section: Luciano Silvestrimentioning

confidence: 95%

Selective digestive decontamination is superior to oropharyngeal chlorhexidine in preventing pneumonia and reducing mortality in critically ill patients

Silvestri

Saene

Folla³

et al. 2010

J. bras. pneumol.

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“…shown to reduce hospital acquired infection rates and mortality in critically ill patients [5][6][7] .…”

Section: Selective Decontamination Of the Digestive Tract (Sdd) Is Anmentioning

confidence: 99%

“…Despite considerable evidence supporting the benefit of SDD [5][6][7] , adoption internationally is low 9,10 . Amongst proposed reasons for this lack of adoption are controversies surrounding prophylactic use of antibiotics and associated risk of antibiotic resistance 11,12 and purported difficulty of SDD implementation and delivery 13 .…”

Section: Selective Decontamination Of the Digestive Tract (Sdd) Is Anmentioning

confidence: 99%

Clinical components and associated behavioural aspects of a complex healthcare intervention: Multi-methods study of selective decontamination of the digestive tract in critical care

Dombrowski

Prior

Duncan

et al. 2013

Australian Critical Care

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Francis, J. (2013). Clinical components and associated behavioural aspects of a complex healthcare intervention: Multi-methods study of selective decontamination of the digestive tract in critical care. Australian Critical Care, 26(4), pp. 173-179. doi: 10.1016/j.aucc.2013.04.002 This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent Authors' contributionsJJF and BHC designed the study. ARB and ACG assisted with recruitment of participants.SUD collected data. SUD and ED analysed the data. All authors provided critical comments on drafts of the analyses and contributed critically for important intellectual content to the manuscript. All authors read and approved the final manuscript and all those entitled to authorship are listed as authors.3 AbstractBackground -This study sought to identify and describe the clinical and behavioural

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Impact of selective decontamination of the digestive tract on multiple organ dysfunction syndrome: Systematic review of randomized controlled trials*

Abstract: Selective decontamination of the digestive tract reduces the number of patients with multiple organ dysfunction syndrome. Mortality was not significantly reduced, probably because of the small sample size.

Cited by 70 publications

References 45 publications

Impact of bloodstream infections on outcome and the influence of prophylactic oral antibiotic regimens in allogeneic hematopoietic SCT recipients

Impact of bloodstream infections on outcome and the influence of prophylactic oral antibiotic regimens in allogeneic hematopoietic SCT recipients

Selective digestive decontamination is superior to oropharyngeal chlorhexidine in preventing pneumonia and reducing mortality in critically ill patients

Clinical components and associated behavioural aspects of a complex healthcare intervention: Multi-methods study of selective decontamination of the digestive tract in critical care

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