Tuesday December 6, 2005
Selective digestive tract decontamination (SDD)
SDD is widely practiced in europe but its use in USA remains low due to fear of increase in antibitics resistance. The technique applies use of oral and enteral nonabsorbable antibiotics (polymyxin B, tobramycin and amphotericin B - new reports suggest benefit of Probiotics) and IV antibiotics (cefotaxime) in the hope to prevent and eradicate oropharyngeal and gastrointestinal carriage of potentially pathogenic microorganisms (PPMs), leaving the indigenous flora, which may protect against overgrowth of resistant bacteria. Most studies favour use of SDD in prevention of ventilator-associated pneumonia (VAP) and overall decrease in ICU mortality. Are we ready to embark on this journey?
References: Click here to get article
1. Selective digestive decontamination decreases mortality and morbidity in the intensive care - Canadian Journal of Anesthesia 51:737-739 (2004)
2. Selective decontamination of the digestive tract reduced intensive care unit and hospital mortality in adults - Evidence-Based Nursing 2004; 7:47
3. Selective decontamination of the digestive tract reduces mortality in critically ill patients - Critical Care 2003, 7:107-110
4. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia - Am. J. Respir. Crit. Care Med., February 15, 2005; 171(4): 388 - 416