• Intensive care medicine · Jan 1992

    Review

    Prevention of pneumonia by selective decontamination of the digestive tract (SDD).

    • C P Stoutenbeek and H K van Saene.
    • Department of Intensive Care, OLVG, Amsterdam, Holland.
    • Intensive Care Med. 1992 Jan 1;18 Suppl 1:S18-23.

    AbstractPrevention of respiratory tract infections is only possible when the pathogenesis is known. Three types of infection can be distinguished: primary endogenous infections, caused by pathogens carried in the throat at the commencement of mechanical ventilation, generally develop early and can only be prevented by intravenous antibiotics. Secondary endogeneous infections, caused by hospital-acquired pathogens, generally develop later and can be prevented by selective decontamination of the digestive tract (SDD). The GI-tract is decontaminated by oral nonabsorbable antibiotics and for oropharyngeal decontamination a sticky antibiotic ointment is used. To date 16 controlled SDD trials in intensive care have been fully published. In all except one study, the pneumonia rate decreased significantly from 40%-50% in controls to about 10% in SDD-treated patients. All studies showed a consistent reduction of ventilator days, ICU-stay and an improved outcome in SDD-treated patients. However, in only few studies did these differences reach statistical significance. Selection of resistant strains has not been observed during prolonged use of SDD. Sucralfate reduces the pneumonia rate compared to H2-blockers or antacids by not interfering with the gastric barrier. However, gastric colonization is reduced rather than eliminated and sucralfate has almost no effect on oropharyngeal or tracheal colonization. Whether sucralfate is significantly better than a placebo remains to be established. SDD is superior to sucralfate in preventing both colonization and infection.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.