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Viewpoint: Survival Benefit by Selective Decontamination of the Digestive Tract (SDD)

Published online by Cambridge University Press:  02 January 2015

H.K.F. van Saene*
Affiliation:
Department of Medical Microbiology, University of Liverpool, Royal Liverpool Children's NHS Trust, Liverpool, England
A.J. Nunn
Affiliation:
Department of Pharmacy, Royal Liverpool Children's NHS Trust, Liverpool, England
A.J. Petros
Affiliation:
Department of Cardiac Intensive Care, Royal Liverpool Children's NHS Trust, Liverpool, England
*
Department of Medical Microbiology, University of Liverpool, PO Box 147, Liverpool L69 3BX, England

Abstract

Morbidity and mortality due to infection acquired either before or after admission to the intensive care unit is still a major problem. A limited range of potentially pathogenic microorganisms (PPM) are involved, and infection with these PPM usually follows a predictable pattern. Selective decontamination of the digestive tract (SDD) should be investigated further in patients with primarily curable diseases who are not infected on admission to intensive care but become infected there.

Type
From the Third International Conference on the Prevention of Infection
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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References

1. Rogers, CJ, van Saene, HKF, Suter, PM, et al. Infection control in critically ill patients: effects of selective decontamination of the digestive tract. Am J Hosp Pharm 1994;51:631648.Google ScholarPubMed
2. Dal Nogare, AR, Toews, GB, Pierce, AK. Increased salivary elastase precedes gram-negative bacillary colonization in postoperative patients. Am Rev Respir Dis 1987;135:671675.Google ScholarPubMed
3. Stoutenbeek, CP, van Saene, HKF, Liberati, A Prevention of respiratory tract infections in intensive care by selective decontamination of the digestive tract. In: Niederman, MS, Sarosi, GA, Glassroth, J, eds. Respiratory Infections. 1st ed. Philadelphia, PA: W.B. Saunders Co; 1994:579594.Google Scholar
4. Brun-Buisson, C, Legrand, P, Rauss, A, et al. Intestinal decontamination for control of nosocomial multi-resistant gram-negative bacilli. Ann Intern Med 1989;110:873881.Google Scholar
5. Verhaegen, J. Randomised study of selective digestive decontamination on and prevention of infections in mechanically ventilated patients in the ICU. Belgium: University of Louvain; 1992. PhD thesis.Google Scholar
6. Timsit, JF, Renaud, B, Misset, B, et al. Effect of selective digestive decontamination with colistin and erythromycin in the control of multi-resistant Acinetobacter baumanii ICU outbreak. Clin Intensive Care 1993;4(suppl 2):P42.Google Scholar
7. Wiesner, RH, Hermans, PE, Rakela, J, et al. Selective bowel decontamination to decrease gram-negative aerobic bacterial and Candida colonization and prevent infection after orthotopic liver transplantation. Transplantation 1989;45:570574.Google Scholar
8. Cerra, FB, Maddaus, MA, Dunn, DL, et al. Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients. Arch Surg 1992;127:163169.Google Scholar
9. De Champs, CL, Guelon, DP, Gamier, RM, et al. Selective digestive decontamination by erythromycin base in a polyvalent intensive care unit. Intensive Care Med 1993;19:191196.Google Scholar
10. Stoutenbeek, CP, van Saene, HKF, Zandstra, DE The effect of oral nonabsorbable antibiotics on the emergence of resistant bacteria in patients in an intensive care unit. J Antimicrob Chemother 1987;19:513520.Google Scholar
11. Vandenbroucke-Grauls, CMJE, Vandenbroucke, JP. Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in the intensive care unit. Lancet 1991;338:859862.Google Scholar
12. Selective Decontamination of the Digestive Tract Trialists' Collaborative Group. Meta-analysis of randomised controlled trials of selective decontamination of the digestive tract. By Med J 1993;307:525532.Google Scholar
13. Heyland, DK, Cook, DJ, Laeschke, R, et al. Selective decontamination of the digestive tract: an overview. Chest 1994;105:12211223.CrossRefGoogle ScholarPubMed
14. Kollef, MH. The role of selective digestive tract decontamination on mortality and respiratory tract infections. Chest 1994;105:11011108.CrossRefGoogle ScholarPubMed
15. Tetteroo, GWM, Wagenvoort, JHT, Mulder, PGH, et al. Decreased mortality rate and length of hospital stay in surgical intensive care unit patients with successful selective decontamination of the gut. Crit Care Med 1993;21:16921698.Google Scholar
16. Anti-platelet Trialists' Collaborative Group. Collaborative overview of trials of anti-platelet therapy in various categories of patients. By Med J 1994;308:81106.CrossRefGoogle Scholar
17. Rocha, LA, Martin, MJ, Pita, S, et al. Prevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. Intensive Care Med 1992;18:398404.CrossRefGoogle ScholarPubMed
18. Korinek, AM, Laisne, MJ, Nicolas, MH, et al. Selective decontamination of the digestive tract in neurosurgical intensive care unit patients: a double blind, randomized, placebo controlled study. Crit Cure Med 1993;21:14661473.Google Scholar
19. Van Saene, HKF, Stoutenbeek, CP, Hart, CA. Selective decontamination of the digestive tract (SDD) in intensive care patients: a critical evaluation of the clinical, bacteriological, and epideimological benefits. J Hosp Infect 1991;18:261277.CrossRefGoogle ScholarPubMed
20. Konrad, F, Schwalbe, B, Heeg, K, et al. Kolonisations, pneumoniefrequenz und resistenzentwicklung bei langzeitbeatmeten intensivpatienten unter selektiver dekontamination des verdauungstraktes. Intensivmed Notfallmed 1989;26:242249.Google Scholar
21. Van Saene, HKF, Unertl, KE, Alcock, SR, et al. Emergence of antibiotic resistance during selective digestive decontamination? J Hosp Infect 1993;24:158161.Google Scholar
22. Van Saene, HKF, Stoutenbeek, CP, Stoller, JK. Selective decontamination of the digestive tract in the intensive care unit: current status and future prospects. Crit Care Med 1992;20:691703.Google Scholar