[Selective bowel decontamination].
Infective complications play major role in mortality of high risk patients demanding intensive care. Selective Bowel Decontamination prevents endogenous infections by reducing the number of potentially pathogen microbes (aerobic bacteria, fungi) in the oropharynx and gastrointestinal tract, saving anaerobic bacteria. It had been used 20 years ago for the first time. Authors survey it's literature ever since. Selective Bowel Decontamination is performed by the mixture of antibiotics and antimycotic drug, administered orally in hydrogel, and suspension form in nasojejunal tube. The number of Gram negative optional aerobic bacteria and fungi decrease significantly in the gut, and the microbial translocation is following this tendency. Foreign authors achieved good results in acute necrotizing pancreatitis, after liver transplant, in polytrauma, in serious burn and in haematological malignancies. According to the literature Selective Bowel Decontamination shows advantages in selected groups of high risk surgical patients. In some studies the administration took few months, but the minimum time was one week. There was no report of increasing MRSA appearance. Regular bacteriological sampling is highly recommended in order to recognize any new antibiotic resistance in time.
Szántó
Zoltán
Z
Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelointézet, Altalános, Er- es Mellkassebészeti Osztály, Szolnok. surgic@freemail.hu
Pulay
István
I
Kotsis
Lajos
L
Dinka
Tibor
T
D016470:Bacteremia / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control*; D001420:Bacteria, Aerobic / Q000187:drug effects; D001421:Bacteria, Anaerobic / Q000187:drug effects; D002056:Burns / Q000150:complications; D005658:Fungi / Q000187:drug effects; D006090:Gram-Negative Bacteria / Q000187:drug effects; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D016031:Liver Transplantation / Q000009:adverse effects; D016106:Methicillin Resistance; D009104:Multiple Trauma / Q000150:complications; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications; D013211:Staphylococcus aureus / Q000187:drug effects