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Selective decontamination of the digestive tract in intensive care

  • S. J. Boom (a1) and G. Ramsay (a1)

Summary

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.

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Copyright

Corresponding author

*Correspondence and reprints: Mr G. Ramsay.

References

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