Survival Benefit in Critically Ill Burned Patients Receiving Selective Decontamination of the Digestive Tract

Cal, Miguel A. de la; Cerdá, Enrique; García-Hierro, P.; Saene, H. K. F. van; Gómez-Santos, D.; Negro, E; Lorente, José A.

doi:10.1097/01.sla.0000154148.58154.d5

Cited by 167 publications

(75 citation statements)

References 28 publications

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“…1,2 Although there is still controversy regarding the universal indication of SID for critical care patients, in 5 of 9 published meta-analyses and in 4 recent randomized studies not included in a previous meta-analysis, a reduction in the mortality related to SID administration could be demonstrated in patients admitted to intensive care units (ICUs), mostly when systemic antibiotics were administered. [1][2][3][4][5][6] Bacterial infections (especially those involving gram-negative bacteria) are major complications for liver transplant recipients (LTRs); their frequency ranges from 20% to 80%. They contribute substantially to longer hospital stays and increased hospital costs 7 and are the leading cause of death in this population.…”

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confidence: 99%

Selective intestinal decontamination with fluoroquinolones for the prevention of early bacterial infections after liver transplantation

et al. 2011

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The role of selective intestinal decontamination with fluoroquinolones (FQ-SID) in the prevention of early bacterial infections (EBIs) in liver transplant recipients (LTRs) is unknown. We used the online database of the Spanish Network of Infection in Transplantation/ Spanish Network for Research in Infectious Diseases, which prospectively analyzed 1010 LTRs from 12 Spanish hospitals from September 2003 to February 2005. We compared the incidence and etiology of EBIs (30 days after transplantation) in 415 LTRs from 4 centers that used FQ-SID (>7 days) and in 595 LTRs from 8 hospitals that did not use FQ-SID. A multivariate logistic regression analysis (including an adjustment for the transplant center factor) was performed to evaluate the potential protective factor of FQ-SID in the development of EBIs. We reported 266 EBI episodes in 252 LTRs (incidence ¼ 24.9%). There were no differences in the incidence of EBIs between patients in the FQ-SID group and patients not in the FQ-SID group [109/415 (26.3%) versus 143/595 (24%), P ¼ 0.9]. Although LTRs who received FQ-SID had a lower incidence of infections due to enteric bacteria (2.7% versus 6.5%, P ¼ 0.007) and a higher incidence of infections due to nonfermenting gram-negative bacilli (6.6% versus 2.6%, P ¼ 0.004), these findings could not be confirmed after an adjustment by the center factor in the multivariate models. We found no significant differences in the incidence of enterococcal infections (3.4% with FQ-SID versus 3.9% without FQ-SID, P ¼ 0.5). Multivariate analysis did not confirm any protective effect of FQ-SID against the development of EBIs by enteric bacteria. In conclusion, FQ-SID does not reduce the incidence of EBIs in LTRs and could be withheld from this group of patients. Liver Transpl 17:896-904,

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confidence: 99%

Selective intestinal decontamination with fluoroquinolones for the prevention of early bacterial infections after liver transplantation

et al. 2011

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“…Afterwards, several randomised studies have found a lower incidence of VAP with SDD [155][156][157][158]; however, a lower mortality rate was not found in some studies [157,158].…”

Section: Pharmacological Measures For Preventing Vapmentioning

confidence: 99%

Evidence on measures for the prevention of ventilator-associated pneumonia

Lorente

Blot²,

Rello³

2007

European Respiratory Journal

134

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“…In another study [103], 107 patients with more than 20% burns and/or suspected inhalation injury were randomised to receive SDD or placebo and mortality rates and incidence of pneumonias were measured. A similar antibiotic regimen to the one used in [97] was used but topical polymixin E substituted colistin.…”

Section: The Evidence On Sddmentioning

confidence: 99%

Sepsis, the Liver and the Gut

Azzopardi¹,

Fenech²,

Piscopo³

2012

Sepsis - An Ongoing and Significant Challenge

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Survival Benefit in Critically Ill Burned Patients Receiving Selective Decontamination of the Digestive Tract

Abstract: Treatment with SDD reduces mortality and pneumonia incidence in patients with severe burns.

Cited by 167 publications

References 28 publications

Selective intestinal decontamination with fluoroquinolones for the prevention of early bacterial infections after liver transplantation

Selective intestinal decontamination with fluoroquinolones for the prevention of early bacterial infections after liver transplantation

Evidence on measures for the prevention of ventilator-associated pneumonia

Sepsis, the Liver and the Gut

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