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

被引：64
作者：
Wittekamp, Bastiaan H. J. [1 ]
Oostdijk, Evelien A. N. [2 ]
Cuthbertson, Brian H. [2 ]
Brun-Buisson, Christian [3 ]
Bonten, Marc J. M. [4 ,5 ]
机构：
[1] Univ Utrecht, Univ Med Ctr Utrecht, Dept Intens Care, Utrecht, Netherlands
[2] Univ Toronto, Univ Dept Anesthesiol & Pain Med, Dept Crit Care Med, Toronto, ON, Canada
[3] Inst Pasteur, Inserm UVSQ, Biostat Biomath Pharmacoepidemiol & Infect Dis B2, Paris, France
[4] Univ Utrecht, Univ Med Ctr Utrecht, Dept Med Microbiol, Utrecht, Netherlands
[5] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
来源：
INTENSIVE CARE MEDICINE | 2020年 / 46卷 / 02期
关键词：
Selective decontamination; Infection prevention; Antibiotic resistance; INTENSIVE-CARE UNITS; ANTIMICROBIAL RESISTANCE; DOUBLE-BLIND; OROPHARYNX; COLONIZATION; FLORA;
D O I：
10.1007/s00134-019-05883-9
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
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.
引用
收藏
页码：343 / 349
页数：7
相关论文
共 50 条
  • [31] Decontamination of the Digestive Tract and Oropharynx in ICU Patients
    de Smet, A. M. G. A.
    Kluytmans, J. A. J. W.
    Cooper, B. S.
    Mascini, E. M.
    Benus, R. F. J.
    van der Werf, T. S.
    van der Hoeven, J. G.
    Pickkers, P.
    Bogaers-Hofman, D.
    van der Meer, N. J. M.
    Bernards, A. T.
    Kuijper, E. J.
    Joore, J. C. A.
    Hall, M. A. Leverstein-van
    Bindels, A. J. G. H.
    Jansz, A. R.
    Wesselink, R. M. J.
    de Jongh, B. M.
    Dennesen, P. J. W.
    van Asselt, G. J.
    Velde, L. F. te
    Frenay, I. H. M. E.
    Kaasjager, K.
    Bosch, F. H.
    van Iterson, M.
    Thijsen, S. F. T.
    Kluge, G. H.
    Pauw, W.
    de Vries, J. W.
    Kaan, J. A.
    Arends, J. P.
    Aarts, L. P. H. J.
    Sturm, P. D. J.
    Harinck, H. I. J.
    Voss, A.
    Uijtendaal, E. V.
    Blok, H. E. M.
    Groen, E. S. Thieme
    Pouw, M. E.
    Kalkman, C. J.
    Bonten, M. J. M.
    NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (01) : 20 - 31
  • [32] Systematic review of perioperative selective decontamination of the digestive tract in elective gastrointestinal surgery
    Roos, D.
    Dijksman, L. M.
    Tijssen, J. G.
    Gouma, D. J.
    Gerhards, M. F.
    Oudemans-van Straaten, H. M.
    BRITISH JOURNAL OF SURGERY, 2013, 100 (12) : 1579 - 1588
  • [33] Selective decontamination of the digestive tract in critically ill patients treated in intensive care units: a mixed-methods feasibility study (the SuDDICU study)
    Francis, Jill J.
    Duncan, Eilidh M.
    Prior, Maria E.
    MacLennan, Graeme S.
    Dombrowski, Stephan U.
    Bellingan, Geoff
    Campbell, Marion K.
    Eccles, Martin P.
    Rose, Louise
    Rowan, Kathryn M.
    Shulman, Rob
    Wilson, A. Peter R.
    Cuthbertson, Brian H.
    HEALTH TECHNOLOGY ASSESSMENT, 2014, 18 (25) : 1 - +
  • [34] Selective decontamination of the digestive tract in burn patients: A systematic review with meta-analysis
    Tsuchiya, Emma Atsuko
    Jensen-Abbew, Jacob
    Krag, Mette
    Moller, Morten Hylander
    Vestergaard, Martin Risom
    Haase, Nicolai
    Helleberg, Marie
    Holmgaard, Rikke
    Heiberg, Johan
    BURNS, 2025, 51 (05)
  • [35] Selective decontamination of the digestive tract and selective oropharyngeal decontamination in intensive care unit patients: a cost-effectiveness analysis
    Oostdijk, Evelien A. N.
    de Wit, G. A.
    Bakker, Marina
    de Smet, Anne Marie G. A.
    Bonten, M. J. M.
    BMJ OPEN, 2013, 3 (03):
  • [36] Carriage of antibiotic-resistant Gram-negative bacteria after discontinuation of selective decontamination of the digestive tract (SDD) or selective oropharyngeal decontamination (SOD)
    E. de Jonge
    R. B. P. de Wilde
    N. P. Juffermans
    E. A. N. Oostdijk
    A. T. Bernards
    E. H. R. van Essen
    E. J. Kuijper
    C. E. Visser
    J. Kesecioglu
    M. J. M. Bonten
    Critical Care, 22
  • [37] PREVENTION OF NOSOCOMIAL INFECTION IN CRITICALLY ILL PATIENTS BY SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT - A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY
    ROCHA, LA
    MARTIN, MJ
    PITA, S
    PAZ, J
    SECO, C
    MARGUSINO, L
    VILLANUEVA, R
    DURAN, MT
    INTENSIVE CARE MEDICINE, 1992, 18 (07) : 398 - 404
  • [38] Decontamination of Oral or Digestive Tract for Patients in the Intensive Care Unit
    Vandenbroucke-Grauls, Christina M. J. E.
    van der Meer, Jos W. M.
    JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2018, 320 (20): : 2081 - 2083
  • [39] The ecological effects of selective decontamination of the digestive tract (SDD) on antimicrobial resistance: a 21-year longitudinal single-centre study
    Buitinck, Sophie
    Jansen, Rogier
    Rijkenberg, Saskia
    Wester, Jos P. J.
    Bosman, Rob J.
    van der Meer, Nardo J. M.
    van der Voort, Peter H. J.
    CRITICAL CARE, 2019, 23 (1):
  • [40] Selective decontamination of the digestive tract: selectivity is not required
    D. F. Zandstra
    A. J. Petros
    L. Silvestri
    M. A. de la Cal
    N. Taylor
    V. Damjanovic
    H. K. F. van Saene
    Intensive Care Medicine, 2010, 36 : 1783 - 1784
12345