title: Selective digestive decontamination in critically ill children: A survey of Canadian providers.
abstract: Selective digestive decontamination of the digestive tract involves the routine administration of oral, gastric, and intravenous antibiotics to mechanically ventilated children to prevent hospital-acquired infections. It has a strong evidence base in adults, with limited pediatric evidence. Current utilization of this intervention among pediatric physicians in North America is unknown.
  
  
  
  An electronic survey administered to pediatric critical care and pediatric infectious disease providers in Canada. Participants were surveyed on current institutional practices, their current knowledge of the evidence base, and perceptions of the risks and benefits of the intervention. Descriptive statistics were utilized.
  
  
  
  50 out of 143 (35%) surveyed responded. No hospital in Canada routinely performs SDD and the majority of respondents (74%) have neutral opinions on the subject of SDD. There was concern for increasing antibiotic resistance (43%) and some disagreement with the intravenous component of SDD (46%). The majority of respondents stated a need for pediatric-specific evidence before integrating SDD into their practice, even if further, large adult RCTs were performed.
  
  
  
  Among surveyed providers, there is little knowledge and no use of selective digestive decontamination for the prevention of hospital-acquired infections. Before interventional studies are performed in pediatric practice, there is a need for study of facilitators, barriers and acceptability of SDD in practice.
authors.affiliation: University of British Columbia, Canada. Electronic address: srinivas.murthy@cw.bc.ca.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Murthy
authors.affiliation: University of Cambridge, United Kingdom.
authors.forename: Nazima
authors.initials: N
authors.lastname: Pathan
authors.affiliation: University of Toronto, Canada.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Cuthbertson
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002170:Canada; D002648:Child; D003422:Critical Care / Q000706:statistics & numerical data; D016638:Critical Illness; D003428:Cross Infection / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods*; D004352:Drug Resistance, Microbial; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D000072143:Pediatricians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000009:adverse effects*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Antibiotics; Hospital acquired infections