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Open Access 01-02-2020 | Antibiotic | Review

Selective decontamination of the digestive tract (SDD) in critically ill patients: a narrative review

Authors: Bastiaan H. J. Wittekamp, Evelien A. N. Oostdijk, Brian H. Cuthbertson, Christian Brun-Buisson, Marc J. M. Bonten

Published in: Intensive Care Medicine | Issue 2/2020

Abstract

Selective decontamination of the digestive tract (SDD) is an infection prevention measure for intensive care unit (ICU) patients that was proposed more than 30 years ago, and that is currently considered standard of care in the Netherlands, but only used sporadically in ICUs in other countries. In this narrative review, we first describe the rationale of the individual components of SDD and then review the evidence base for patient-centered outcomes, where we distinguish ICUs with low prevalence of antibiotic resistance from ICUs with moderate–high prevalence of resistance. In settings with low prevalence of antibiotic resistance, SDD has been associated with improved patient outcome in three cluster-randomized studies. These benefits were not confirmed in a large international cluster-randomized study in settings with moderate-to-high prevalence of antibiotic resistance. There is no evidence that SDD increases antibiotic resistance. We end with future directions for research.

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Title: Selective decontamination of the digestive tract (SDD) in critically ill patients: a narrative review
Authors: Bastiaan H. J. Wittekamp
Evelien A. N. Oostdijk
Brian H. Cuthbertson
Christian Brun-Buisson
Marc J. M. Bonten
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Antibiotic
Cephalosporin Antibiotic
Published in: Intensive Care Medicine / Issue 2/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-019-05883-9

At a glance: The STEP trials

Springer Medicine

Selective decontamination of the digestive tract (SDD) in critically ill patients: a narrative review

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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