Prevention of Infection in Critically Ill Patients by Selective Decontamination of the Digestive Tract

Abstract

Selective decontamination of the digestive tract decreases subsequent infection rates, especially by gram-negative bacilli, in selected patients during long-term stays in the intensive care unit.

Selective decontamination in European intensive care patients

“…Today, the commercial price of SDD and SOD would be around €200 and €40 per day, respectively. Since the necessity of amphotericin B as a component of SDD has never been determined, it might be worthwhile to investigate SDD with other topical antimycotic agents (e.g., nystatin) [22–25]. …”

Selective digestive decontamination in multiple trauma patients: Cost and efficacy

“…These non-absorbable antimicrobial agents were selected because of their spectrum of activity (non-toxic for the anaerobic flora) and cost. In previous studies tobramycin was used instead of gentamicin, and/or polymyxin instead of colistin, and/or nystatin instead of amphotericin B [13][14][15][16][17]. Neomycin or a quinolone (nalidixic acid or norfloxacin) has sometimes been used instead of the aminoglycoside [1 3 16 18].…”

Doctors' perceptions of the effects of interventions tested in prospective, randomised, controlled, clinical trials: results of a survey of ICU physicians

“…Also, the effects of many of the interventions cited, such as immunonutrition [10, 11,12,13,14,15,16], are still controversial. Selective digestive decontamination [17,18,19], a good example of a preventive intervention rather than a treatment, was listed as being beneficial by our respondents, but despite the significant reduction in mortality suggested by the most recent meta-analysis of RCTs in this area [19], selective digestive decontamination is not in widespread use.…”