Randomized, controlled trial of selective digestive decontamination in 600 mechanically ventilated patients in a multidisciplinary intensive care unit

Critical Care Medicine

Volumn 25, Issue 1, 1997, Pages 63-71

  Verwaest, Charles ^a   Verhaegen, Jan ^a   Ferdinande, Patrick ^a   Schetz, Miet ^a   Van Den Berghe, Greet ^a   Verbist, Ludo ^a   Lauwers, Peter ^a  

^a UNIVERSITY HOSPITALS LEUVEN   (Belgium)

Author keywords

antimicrobial costs; colonization, gastrointestinal; decontamination; endotracheal intubation; fluoroquinolones; intensive care unit; microorganisms; mortality; nosocomial infection; resistance, antimicrobial

Indexed keywords

AMPHOTERICIN B; CEFOTAXIME; COLISTIN; OFLOXACIN; TOBRAMYCIN;

ADULT; AGED; ANTIBIOTIC RESISTANCE; ANTIBIOTIC THERAPY; ARTICLE; ARTIFICIAL VENTILATION; BACTERIAL COLONIZATION; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DRUG EFFICACY; FEMALE; HUMAN; HUMAN CELL; HUMAN TISSUE; INFECTION RATE; INTENSIVE CARE UNIT; INTRAGASTRIC DRUG ADMINISTRATION; MAJOR CLINICAL STUDY; MALE; ORAL DRUG ADMINISTRATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL;

ADULT; AGED; ANTI-BACTERIAL AGENTS; BACTERIAL INFECTIONS; BELGIUM; CROSS INFECTION; DECONTAMINATION; DIGESTIVE SYSTEM; DRUG RESISTANCE, MICROBIAL; FEMALE; HOSPITAL BED CAPACITY, 500 AND OVER; HOSPITAL MORTALITY; HOSPITALS, UNIVERSITY; HUMANS; INFECTION CONTROL; INTENSIVE CARE UNITS; LENGTH OF STAY; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; RESPIRATION, ARTIFICIAL;

EID: 0031012348     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/00003246-199701000-00014     Document Type: Article

References (36)

1. Daschner FD, Frey P, Wolff G, et al: Nosocomial infections in intensive care wards: A multicenter prospective study. Intensive Care Med 1982; 8:5-9
2. Stoutenbeek CP, van Saene HKF, Miranda DR, et al: The effect of selective decontamination of the digestive tract on colonization and infection rate in multiple trauma patients. Intensive Care Med 1984; 10:185-192
3. Celis R, Torres A, Gatell JM: Nosocomial pneumonia: A multivariate analysis of risk and prognosis. Chest 1988; 93:3198-3224
4. Craven DE, Steger KA: Nosocomial pneumonia in the intubated patient. New concepts on pathogenesis and prevention. Infect Dis Clin North Am 1989; 3:843-866
5. Stevens RM, Teres D, Skillman JJ, et al: Pneumonia in an intensive care unit. Arch Intern Med 1974; 134:106-111
6. White R, Dilwoth P: Pneumonia in hospital. Br J Dis Chest 1988; 82:121-126
7. Stoutenbeek CP: The role of systemic antibiotic prophylaxis in infection prevention in intensive care by selective decontamination. Infection 1989; 17:418-421
8. van Uffelen R, Rommes JH, van Saene HKF: Preventing lower airway colonization and infection in mechanically ventilated patients. Crit Care Med 1987; 15:99-102
9. Unertl K, Ruckdeschel G, Selbmann HK, et al: Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis. Intensive Care Med 1987; 13:106-113
10. Sydow M, Burchardi H, Crozier TA, et al: Einflub der Selektiven Dekontamination auf Nosokomiale Infektionen, Erregerspektrum und Antibiotika Resistenz bei Lang- zeitbeatmeten Intensivpatienten. Anästh Intensivther Notfallmed 1990; 25: 416-423
11. Kerver AJH, Rommes JH, Mevissen-Verhage EAE, et al: Prevention of colonization and infection in critically ill patients: A prospective randomized study. Crit Care Med 1988; 16:1087-1093
12. Ledingham IMcA, Alcock SR, Estaway AT, et al: Triple regimen of selective decontamination of the digestive tract, systemic cefotaxime and microbial surveillance for prevention of acquired infection in intensive care. Lancet 1988; i:785-790
13. Ulrich C, Harinck-de Weerd JE, Bakker NC, et al: Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: A prospective randomized study. Intensive Care Med 1989; 15:424-431
14. Konrad F, Schwalbe B, Heeg K, et al: Kolonisations-, Pneumoniefrequenz und Resistenzentwicklung bei langzeitbeatmeten Intensivpatienten unter selektiver Dekontamination des Verdauungstraktes. Anaesthesist 1989; 38:99-109
15. Thülig B, Hartenauer U, Diemer W, et al: Selektive Florasuppression zur Infektionskontrolle in der operativen Intensivmedizin. Anästh Intensivther Notfallmed 1989; 24:345-354
16. Hunefeld G: A clinical study of selective gut decolonization in 204 long-term ventilated intensive care patients undergoing abdominal and accident surgery. Anaesthesiol Reanim 1989; 14:131-153
17. Aerdts SJA, Clasener HAL, van Dalen R, et al: Prevention of bacterial colonization of the respiratory tract and stomach of mechanically ventilated patients by a novel regimen of selective decontamination in combination with initial systemic cefotaxime. J Antimicrob Chemother 1990; 26(Suppl A):59-76
18. Brun-Buisson C, Legrand P, Rauss A, et al: Intestinal decontamination for control of nosocomial multiresistant Gram-negative bacilli. Study of an outbreak in an intensive care unit. Ann Intern Med 1989; 110:873-881
19. Tetteroo GWM, Wagenvoort JHT, Castelein A, et al: Selective decontamination to reduce Gram-negative colonization and infections after oesophageal resection. Lancet 1990; 335:704-707
20. Blair P, Rowlands BJ, Lowry K, et al: Selective decontamination of the digestive tract: Stratified, randomized, prospective study in a mixed intensive care unit. Surgery 1991; 110:303-310
21. Gastinne H, Wolff M, Delatour F, et al: A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. N Engl J Med 1992; 326:594-599
22. Hammond JM, Potgieter PD, Saunders GL, et al: A double blind study of selective decontamination in intensive care. Lancet 1992; 340:5-9
23. Cockerill FR, Muller SR, Anhalt JP, et al: Prevention of infection in critically ill patients by selective decontamination of the digestive tract. Ann Intern Med 1992; 117:545-553
24. Ferrer M, Torres A, Gonzales J, et al: Utility of selective digestive decontamination in mechanically ventilated patients. Ann Intern Med 1994; 120: 389-395
25. Hammond JMJ, Potgieter PD, Saunders GL: Selective decontamination of the digestive tract in multiple trauma patients - Is there a role? Results of a prospective, double-blind, randomized trial. Crit Care Med 1994; 22:33-39
26. Vandenbroucke-Grauls CMJ, Vandenbroucke JP: Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in the intensive care unit. Lancet 1991; 338:859-862
27. Selective Decontamination of the Digestive Tract Trialists' Collaborative Group: Meta-analysis of randomized controlled trials of selective decontamination of the digestive tract. BMJ 1993; 307:525-532
28. Heyland DK, Cook DJ, Jaeschke R, et al: Selective decontamination of the digestive tract: An overview. Chest 1994; 105:1221-1229
29. Hurley JC: Prophylaxis with enteral antibiotics in ventilated patients: Selective decontamination or selective cross-infection? Antimicrob Agents Chemother 1995; 39:941-947
30. Niedermann MS: Pathogenesis of colonization/infection of lower airways (endogenous vs. exogenous): Conventional approaches of infection control. In: Infection Control by Selective Decontamination, van Saene HKF, Stoutenbeek CP, Lawin P, et al (Eds). In: Update in Intensive Care and Emergency Medicine. Vol 7. Berlin, Heidelberg, New York, Tokyo, Springer-Verlag, 1989, pp 42-48
31. Saunders GL, Hammond JM, Potgieter PD, et al: Microbiological surveillance during selective decontamination of the digestive tract (SDD). J Antimicrob Chemother 1994; 34:529-544
32. McCarthy DM: Sucralfate. N Engl J Med 1991; 325:1017-1025
33. Nix ED, Watson WA, Handy L, et al: The effect of sucralfate pretreatment on the pharmacokinetics of ciprofloxacin. Pharmacotherapy 1989; 9:377-380
34. Stoutenbeek CP, van Saene HKF, Zandstra DF: The effect of oral non-absorbable antibiotics on the emergence of resistant bacteria in patients in an intensive care unit. J Antimicrob Chemother 1987; 19:513-520
35. Bonten M, van Tiel F, van der Geest S, et al: Enterococcus faecalis pneumonia complicating topical antimicrobial prophylaxis. N Engl J Med 1992; 328: 209-210
36. Pugin J, Auckenthaler R, Lew DP, et al: Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. JAMA 1991; 265: 2704-2710