Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomized, controlled trials

Silvestri, Luciano; Saene, H. K. F. van; Milanese, Marco; Gregori, Darío; Gullo, Antonino

doi:10.1016/j.jhin.2006.10.014

Cited by 189 publications

(123 citation statements)

References 91 publications

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“…Decrease Variable Variable Variable Probable decrease [78][79][80] Daily assessment of readiness to wean Decrease Decrease Decrease Decrease Possible decrease [82] Daily interruption of sedation…”

Section: Variable No Impact No Impact No Impactmentioning

confidence: 99%

“…Van Nieuwenhoven and colleagues thoughtfully analyzed this literature approximately 10 years ago and demonstrated an inverse relationship between methodological quality and impact upon VAP rates [78]. Nonetheless, a meta-ana lysis of more than 30 such trials published in 2007 found a statistically significant decrease in the incidence of VAP, bacteremia and mortality [79].…”

Section: Reviewmentioning

confidence: 99%

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Prevention of ventilator-associated pneumonia

Klompas¹

2010

Expert Review of Anti-infective Therapy

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Section: Variable No Impact No Impact No Impactmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Prevention of ventilator-associated pneumonia

Klompas¹

2010

Expert Review of Anti-infective Therapy

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“…SDD involves the prophylactic application of topical non-absorbable antibiotics to the oropharynx and stomach with a short course of intravenous antibiotics. Despite much interest over many years and a large evidence base (36 randomised controlled studies) suggesting efficacy in reducing rates of HAIs and increasing survival [1][2][3][4][5][6][7][8][9] SDD has not been widely adopted into intensive care practice worldwide. SDD continues to be a controversial subject, and seems to receive limited support from clinicians [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…The content of each of the domains is described in Table 1. The controversial nature of SDD and the uncertainty about its evidence base [1][2][3][4][5][6][7][8][9]15,16] suggests that clinicians both within and between different clinical specialities and professional groups may hold opposing views. This study therefore applied Delphi methodology to systematically assess agreement/disagreement with SDD within ICU healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

“…We aimed to identify the range of beliefs, interpretation and views about the current evidence base relating to the use of SDD in key stakeholder groups and answer the following research questions: (1) What are the views of key stakeholders of the internal / external validity and adequacy of the existing evidence base for SDD, and how willing are they to participate in further research? (2) What are the views of key stakeholders about the likely positive and negative consequences of implementing SDD in ICUs?…”

Section: Introductionmentioning

confidence: 99%

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The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study

Duncan

Cuthbertson

Prior

et al. 2014

Journal of Critical Care

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link Materials and MethodsParticipants were health professionals with 'decisional authority' for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDD adoption, delivery and further SDD research were explored. Directed content analysis of interview data identified sub-themes which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored.Results 141 participants provided interview data. Fifty-six sub-themes were identified; 46 were common across regions. Beliefs about consequences was the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as worry, anxiety and fear when discussing potential antibiotic resistance associated with SDD. ConclusionsWe identified salient beliefs, barriers and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty and concern that SDD evokes.

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Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care

D'Amico

Pifferi

Torri

et al. 2009

Cochrane Database of Systematic Reviews

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Background Pneumonia is an important cause of mortality in intensive care units (ICUs). The incidence of pneumonia in ICU patients ranges between 7% and 40%, and the crude mortality from ventilator-associated pneumonia may exceed 50%. Although not all deaths in patients with this form of pneumonia are directly attributable to pneumonia, it has been shown to contribute to mortality in ICUs independently of other factors that are also strongly associated with such deaths. Objectives To assess the e ects of prophylactic antibiotic regimens, such as selective decontamination of the digestive tract (SDD) for the prevention of respiratory tract infections (RTIs) and overall mortality in adults receiving intensive care.

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Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomized, controlled trials

Cited by 189 publications

References 91 publications

Prevention of ventilator-associated pneumonia

Prevention of ventilator-associated pneumonia

The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study

Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care

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