title: Topical antimicrobial prophylaxis of nosocomial pneumonia in mechanically ventilated patients. Microbiological observations.
abstract: Generally, reduction of colonization and infection with potentially pathogenic microorganisms in intensive care units (ICU) is attempted by a combination of antimicrobial agents administered topically in the digestive tract and systematically. We tested the efficacy of topical antimicrobial prophylaxis of the oropharynx and stomach administered in combination with sucralfate without systemic prophylaxis in 25 mechanically ventilated ICU patients. The regimen successfully reduced colonization with potentially pathogenic microorganisms in the oropharynx and trachea without modifying the intestinal flora. However, colonization and infections with gram-positive cocci and gram-negative rods other than Enterobacteriaceae and Pseudomonadaceae and resistant to one or both the antimicrobial agents used were observed.
authors.affiliation: Dept. of Internal Medicine, University Hospital Maastricht, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bonten
authors.forename: F H
authors.initials: FH
authors.lastname: van Tiel
authors.forename: S
authors.initials: S
authors.lastname: van der Geest
authors.forename: H G
authors.initials: HG
authors.lastname: Smeets
authors.forename: E E
authors.initials: EE
authors.lastname: Stobberingh
authors.forename: C A
authors.initials: CA
authors.lastname: Gaillard
mesh_terms: D000281:Administration, Intranasal; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000517:prevention & control*; D004755:Enterobacteriaceae / Q000302:isolation & purification*; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D006801:Humans; D007362:Intensive Care Units; D007422:Intestines / Q000382:microbiology; D007441:Intubation, Gastrointestinal; D009960:Oropharynx / Q000382:microbiology*; D011014:Pneumonia / Q000517:prevention & control*; D012121:Respiration, Artificial; D014132:Trachea / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents