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Critical Care
Published in: Critical Care 1/2021

Open Access 01-12-2021 | Antibiotic | Viewpoint

Selective digestive decontamination, a seemingly effective regimen with individual benefit or a flawed concept with population harm?

Author: James C. Hurley

Published in: Critical Care | Issue 1/2021

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Abstract

Selective digestive decontamination (SDD) regimens, variously constituted with topical antibiotic prophylaxis (TAP) and protocolized parenteral antibiotic prophylaxis (PPAP), appear highly effective for preventing ICU-acquired infections but only within randomized concurrent control trials (RCCT’s). Confusingly, SDD is also a concept which, if true, implies population benefit. The SDD concept can finally be reified  in humans using the broad accumulated evidence base, including studies of TAP and PPAP that used non-concurrent controls (NCC), as a natural experiment. However, this test implicates overall population harm with higher event rates associated with SDD use within the ICU context.
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Metadata
Title
Selective digestive decontamination, a seemingly effective regimen with individual benefit or a flawed concept with population harm?
Author
James C. Hurley
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2021
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-021-03744-w

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