Selective decontamination of the digestive tract in intensive care.
Nosocomial infection in intensive care unit (ICU) practice is a common problem and is associated with abnormal carriage of Gram-negative aerobic bacilli in the gastrointestinal tract, resulting in endogenous infections. Selective decontamination of the digestive tract (SDD) is a regimen aimed at preventing or eradicating this abnormal carriage. A large number of trials examining SDD in ICU practice have been published, the vast majority showing a significant reduction in the incidence of nosocomial, Gram-negative infection. However, the impact on morbidity and mortality is much less certain. A recent meta-analysis has suggested a 10-20% reduction in mortality (3-6% absolute difference) with SDD. A discussion of these results is presented together with potential criticisms of SDD.
Boom
S J
SJ
University Department of Surgery, Western Infirmary, Glasgow.
Ramsay
G
G
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003422:Critical Care / Q000379:methods*; D003428:Cross Infection / Q000188:drug therapy / Q000517:prevention & control*; D004064:Digestive System / Q000382:microbiology*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans
D000900:Anti-Bacterial Agents