Impact of selective decontamination of the digestive tract on carriage and infection due to Gram-negative and Gram-positive bacteria: A systematic review of randomised controlled trials

Anaesthesia and Intensive Care

Volumn 36, Issue 3, 2008, Pages

  Silvestri, L ^a   Van Saene, H K F ^a   Casarin, A ^a   Berlot, G ^a   Gullo, A ^a  

^a Ospedale Civile di Gorizia   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

AMIKACIN; AMOXICILLIN PLUS CLAVULANIC ACID; AMPICILLIN; ANTIINFECTIVE AGENT; CEFAZOLIN; CEFOTAXIME; CEFTIZOXIME; CEFTRIAXONE; CIPROFLOXACIN; FLUCLOXACILLIN; GENTAMICIN; METRONIDAZOLE; NALIDIXIC ACID; NEOMYCIN; NETILMICIN; NORFLOXACIN; NYSTATIN; OFLOXACIN; PIPERACILLIN; POLYMYXIN; PSEUDOMONIC ACID; TOBRAMYCIN; TRIMETHOPRIM; VANCOMYCIN;

ARTICLE; BACTERIAL COLONIZATION; BACTERIAL INFECTION; BACTERIUM DETECTION; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; DIGESTIVE SYSTEM; GRAM NEGATIVE BACTERIUM; GRAM POSITIVE BACTERIUM; HUMAN; INFECTION CONTROL; LOWER RESPIRATORY TRACT INFECTION; RANDOMIZED CONTROLLED TRIAL; SEPSIS; STOMACH LAVAGE; SYSTEMATIC REVIEW; GRAM NEGATIVE INFECTION; INTENSIVE CARE; META ANALYSIS; MICROBIOLOGY; PUBLISHING; REVIEW; RISK; STATISTICAL ANALYSIS;

DATA INTERPRETATION, STATISTICAL; DIGESTIVE SYSTEM; GRAM-NEGATIVE BACTERIAL INFECTIONS; GRAM-POSITIVE BACTERIAL INFECTIONS; HUMANS; INTENSIVE CARE; ODDS RATIO; PUBLICATION BIAS; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 44449084310     PISSN: 0310057X     EISSN: None     Source Type: Journal    
DOI: 10.1177/0310057x0803600304     Document Type: Article

References (99)

1. van Saene HKF, Petros AJ, Ramsay G, Baxby D. All great truths are iconoclastic: selective decontamination of the digestive tract moves from heresy to level 1 truth. Intensive Care Med 2003; 29:677-690
2. Silvestri L, Mannucci F, van Saene HKF. Selective decontamination of the digestive tract: a life saver. J Hosp Infect 2000; 45:185-190
3. 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
4. Selective Decontamination of the Digestive Tract Trialists' Collaborative Group. Meta-analysis of randomised controlled trials of selective decontamination of the digestive tract. BMJ 1993; 307:525-532
5. Kollef M. The role of selective digestive tract decontamination on mortality and respiratory tract infections. A meta-analysis. Chest 1994; 105:1101-1108
6. Heyland DK, Cook DJ, Jaeschke R, Griffith L, Lee HN, Guyatt GH. Selective decontamination of the digestive tract: an overview. Chest 1994; 105:1221-1229
7. Hurley JC. Prophylaxis with enteral antibiotics in ventilated patients: selective decontamination or selective cross-infection? Antimicrob Agents Chemother 1995; 39:941-947
8. D'Amico R, Pifferi S, Leonetti C, Torri V, Tinazzi A, Liberati A. Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 1998; 316:1275-1285
9. Nathens AB, Marshall JC. Selective decontamination of the digestive tract in surgical patients. A systematic review of the evidence. Arch Surg 1999; 134:170-176
10. Redman R, Ludington E, Crocker M et al. Analysis of respiratory and non-respiratory infections in published trials of selective digestive decontamination. Intensive Care Med 2001; 27(Suppl 2):S285
11. Safdar N, Said A, Lucey MR. The role of selective digestive decontamination for reducing infection in patients undergoing liver transplantation: a systematic review and meta-analysis. Liver Transpl 2004; 10:817-827
12. Liberati A, D'Amico R, Pifferi S, Leonetti C, Torri V, Brazzi L et al. Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev 2004; 1:CD000022
13. Silvestri L, van Saene HK, Milanese M, Gregori D. Impact of selective decontamination of the digestive tract on fungal carriage and infection: systematic review of randomised controlled trials. Intensive Care Med 2005; 31:898-910
14. Silvestri L, van Saene HK, Milanese M, Gregori D, Gullo A. Selective decontamination of the digestive tract reduces bacterial bloodstream infections and mortality in critically ill patients. Systematic review of randomized, controlled trials. J Hosp Infect 2007; 65:187-203
15. Brazzi L, Liberati A.. A review of design and conduct of the available studies on selective decontamination of the digestive tract. Reanimation Urgences 1992; 1:501-507
16. Heyland DK, Novak F, Drover JW, Jain M, Su X, Suchner U. Should immunonutrition become routine in critically ill patients? A systematic review of the evidence. JAMA 2001; 286:944-953
17. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327:557-560
18. Cucherat M, Boissel JP, Leizorovicz A. EasyMA: a program for the meta-analysis of clinical trials. Comput Methods Programs Biomed 1997; 53:187-190
19. Martinez-Pellús AE, Merino P, Bru M, Conejero R, Seller G, Muñoz C et al. Can selective digestive decontamination avoid the endotoxemia and cytokine activation promoted by cardiopulmonary bypass? Crit Care Med 1993; 21:1684-1891
20. Martinez-Pellús AE, Merino P, Bru M, Canovas J, Seller G, Sapiña J et al. Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Role of type of flow and protective effect of selective digestive decontamination. Intensive Care Med 1997; 23:1251-1257
21. Abele-Horn M, Dauber A, Bauernfeind A, Russwurm W, Seyfarth-Metzger I, Gleich P et al. Decrease in nosocomial pneumonia in ventilated patients by selective oropharyngeal decontamination (SOD). Intensive Care Med 1997; 23:187-195
22. Aerdts SJ, van Dalen R, Clasener HA, Festen J, van Lier HJ, Vollaard EJ. Antibiotic prophylaxis of respiratory tract infection in mechanically ventilated patients. A prospective, blinded, randomized trial of the effect of a novel regimen. Chest 1991; 100:783-791
23. Arnow PM, Carandang GC, Zabner R, Irwin ME. Randomized controlled trial of selective decontamination for prevention of infections following liver transplantation. Clin Infect Dis 1996; 22:997-1003
24. Barret JP, Jeschke MG, Herndon DN. Selective decontamination of the digestive tract on severely burned pediatric patients. Burns 2001; 27:439-445
25. Bergmans DC, Bonten MJ, Gaillard CA, Paling JC, van der Geest S, van Tiel FH et al. Prevention of ventilator-associated pneumonia by oral decontamination. A prospective, randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med 2001; 164:382-388
26. Bion JF, Badger I, Crosby HA, Hutchings P, Kong KL, Baker J et al. Selective decontamination of the digestive tract reduces Gram-negative pulmonary colonization but not systemic endotoxemia in patients undergoing elective liver transplantation. Crit Care Med 1994; 22:40-49
27. Blair P, Rowlands BJ, Lowry K, Webb H, Armstrong P, Smilie J. Selective decontamination of the digestive tract: a stratified, randomized, prospective study in a mixed intensive care unit. Surgery 1991; 110:303-310
28. Boland JP, Sadler DL, Stewart W et al. Reduction of nosocomial respiratory tract infections in the multiple trauma patients requiring mechanical ventilation by selective parenteral and enteral antisepsis regimen (SPEAR) in the intensive care (abstract). 17th Congress of Chemotherapy, Berlin, 1991;No0465
29. Bouter H, Schippers EF, Luelmo SA, Versteegh MI, Ros P, Guiot HF et al. No effect of preoperative selective gut decontamination on endotoxemia and cytokine activation during cardiopulmonary bypass: a randomized, placebo-controlled study. Crit Care Med 2002; 30:38-43
30. Brun-Buisson C, Legrand P, Rauss A, Richard C, Montravers F, Besbes M 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
31. Camus C, Bellissant E, Sebille V, Perrotin D, Garo B, Legras A et al. Prevention of acquired infections in intubated patients with the combination of two decontamination regimens. Crit Care Med 2005; 33:307-314
32. Cerra FB, Maddaus MA, Dunn DL, Wells CL, Konstantinides NN, Lehmann SL et al. Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients. Arch Surg 1992; 127:163-169
33. Cockerill FR 3rd, Muller SR, Anhalt JP, Marsh HM, Farnell MB, Mucha P et al. Prevention of infection in critically ill patients by selective decontamination of the digestive tract. Ann Intern Med 1992; 117:545-553
34. de la Cal MA, Cerdá E, García-Hierro P, van Saene HK, Gómez-Santos D, Negro E et al. Survival benefit in critically ill burned patients receiving selective decontamination of the digestive tract. A randomized, placebo-controlled, double-blind trial. Ann Surg 2005; 241:424-430
35. de Jonge E, Schultz MJ, Spanjaard L, Bossuyt PM, Vroom MB, Dankert J et al. Effects of selective decontamination of the digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet 2003; 362:1011-1016
36. Ferrer M, Torres A, González J, Puig de la Bellacasa J, el-Ebiary M, Roca M et al. Utility of selective decontamination in mechanically ventilated patients. Ann Intern Med 1994; 120:389-395
37. Finch RG, Tomlinson P, Holliday M. Selective decontamination of the digestive tract (SDD) in the prevention of secondary sepsis in a medical/surgical intensive care unit (abstract). 17th Congress of Chemotherapy, Berlin, 1991;No0471
38. Flaherty J, Nathan C, Kabins SA, Weinstein RA. Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit. J Infect Dis 1990; 162:1393-1397
39. Gastinne H, Wolff M, Delatour F, Faurisson F, Chevret S. 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
40. Gaussorgues Ph, Salord F, Sirodot M et al. Efficacite de la decontamination digestive sur la survenue des bacteriemies nosocomiales chez les patients sous ventilation mecanique et recevant des betamimetiques. Rean Soins Intens Med Urg 1991; 7:169-174
41. Georges B, Mazerolles M, Decun J-F et al. Decontamination digestive selective: resultats d'une etude chez le polytraumatise. Reanimation Urgences 1994; 3:621-627
42. Gosney M, Martin MV, Wright AE. The role of selective decontamination of the digestive tract in acute stroke. Age Ageing 2006; 35:42-47
43. Hammond JM, Potgieter PD, Saunders GL, Forder AA. Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet 1992; 340:5-9
44. Hellinger WC, Yao JD, Alvarez S, Blair JE, Cawley JJ, Paya CV et al. A randomized, prospective, double blinded evaluation of selective bowel decontamination in liver transplantation. Transplantation 2002; 73:1904-1909
45. Jacobs S, Foweraker JE, Roberts SE. Effectiveness of selective decontamination of the digestive tract (SDD) in an ICU with a policy encouraging a low gastric pH. Clinical Intensive Care 1992; 3:52-58
46. Kerver AJ, Rommes JH, Mevissen-Verhage EA, Hulstaert PF, Vos A, Verhoef J et al. Prevention of colonization and infection in critically ill patients: a prospective randomized study. Crit Care Med 1988; 16:1087-1093
47. Korinek AM, Laisne MJ, Nicolas MH, Raskine L, Deroin V, Sanson-Lepors MJ. Selective decontamination of the digestive tract in neurosurgical intensive care unit patients: a double-blind, randomized, placebo-controlled study. Crit Care Med 1993; 21:1466-1473
48. Krueger WA, Lenhart FP, Neeser G, Ruckdeschel G, Schreckhase H, Eissner HJ et al. Influence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions, and mortality in critically ill surgical patients. A prospective, stratified, randomized, double-blind, placebo-controlled clinical trial. Am J Respir Crit Care Med 2002; 166:1029-1037
49. Laggner AN, Tryba M, Georgopoulos A, Lenz K, Grimm G, Graninger W et al. Oropharyngeal decontamination with gentamycin for long-stay ventilated patients on stress ulcer prophylaxis with sucralfate? Wien Klin Wochenschr 1994; 106:15-19
50. Lingnau W, Berger J, Javorsky F, Lejeune P, Mutz N, Benzer H. Selective intestinal decontamination in multiple trauma patients: prospective, controlled trial. J Trauma 1997; 42:687-694
51. Luiten EJ, Hop WC, Lange JF, Bruining HA. Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis. Ann Surg 1995; 222:57-65
52. Palomar M, Alvarez-Lerma F, Jorda R et al. Prevention of nosocomial infection in mechanically ventilated patients: selective digestive decontamination versus sucralfate. Clinical Intensive Care 1997; 8:228-235
53. Pneumatikos I, Koulouras V, Nathanail C, Goe D, Nakos G. Selective decontamination of subglottic area in mechanically ventilated patients with multiple trauma. Intensive Care Med 2002; 28:432-437
54. Pugin J, Auckenthaler R, Lew DP, Suter PM. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. JAMA 1991; 265:2704-2710
55. Quinio B, Albanèse J, Bues-Charbit M, Viviand X, Martin C. Selective decontamination of the digestive tract in multiple trauma patients. A prospective double-blind, randomized, placebo-controlled study. Chest 1996; 109:765-772
56. Rayes N, Hansen S, Seehofer D, Müller AR, Serke S, Bengmark S et al. Early enteral supply of Lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation 2002; 74:123-128
57. Rocha LA, Martín MJ, Pita S, Paz J, Seco C, Margusino L et al. Prevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. A randomized, double blind, placebo-controlled study. Intensive Care Med 1992; 18:398-404
58. Rodríguez-Roldán JM, Altuna-Cuesta A, López A, Carrillo A, Garcia J, León J et al. Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med 1990; 18:1239-1242
59. Rolando N, Gimson A, Wade J, Philpott-Howard J, Casewell M, Williams R. Prospective controlled trial of selective parenteral and enteral antimicrobial regimen in fulminant liver failure. Hepatology 1993; 17:196-201
60. Rolando N, Wade JJ, Stangou A, Gimson AE, Wendon J, Philpott-Howard J et al. Prospective study comparing the efficacy of prophylactic parenteral antimicrobials, with or without enteral decontamination, in patients with acute liver failure. Liver Transpl Surg 1996; 2:8-13
61. Ruza F, Alvarado F, Herruzo R, Delgado MA, García S, Dorao P et al. Prevention of nosocomial infection in a pediatric intensive care unit (PICU) through the use of selective digestive decontamination. Eur J Epidemiol 1998; 14:719-727
62. Sánchez García M, Cambronero Galache JA, López Diaz J, Cerdá Cerdá E, Rubio Blasco J, Gómez Aguinaga MA et al. Effectiveness and cost of selective decontamination of the digestive tract in critically ill intubated patients. A randomized, double-blind, placebo-controlled, multicenter trial. Am J Respir Crit Care Med 1998; 158:908-916
63. Schardey HM, Joosten U, Finke U, Staubach KH, Schauer R, Heiss A et al. The prevention of anastomotic leakage after total gastrectomy with local decontamination. A prospective, randomized, double-blind, placebo-controlled, multicenter trial. Ann Surg 1997; 225:172-180
64. Smith SD, Jackson RJ, Hannakan CJ, Wadowsky RM, Tzakis AG, Rowe MI. Selective decontamination in pediatric liver transplants. A randomized prospective study. Transplantation 1993; 55:1306-1309
65. Stoutenbeek CP, van Saene HKF, Zandstra DF. Prevention of multiple organ failure by selective decontamination of the digestive tract in multiple trauma patients. In: Faist E, Baue AE, Schildberg FW, eds. The immune consequences of trauma, shock and sepsis - mechanisms and therapeutic approach. Lengerich: Pabst Science Publishers 1996. p. 1055-1066
66. Stoutenbeek CP, van Saene HK, Little RA, Whitehead A; Working Group on Selective Decontamination of the Digestive Tract. The effect of selective decontamination of the digestive tract on mortality in multiple trauma patients: a multicenter randomized controlled trial. Intensive Care Med 2007; 33:261-270
67. Tetteroo GW, Wagenvoort JH, Castelein A, Tilanus HW, Ince C, Bruining HA. Selective decontamination to reduce gramnegative colonisation and infections after oesophageal resection. Lancet 1990; 335:704-707
68. Ulrich C, Harinck-de Weerd JE, Bakker NC, Jacz K, Doornbos L, de Ridder VA. 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
69. Unertl K, Ruckdeschel G, Selbmann HK, Jensen U, Forst H, Lenhart FP et al. Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis. Intensive Care Med 1987; 13:106-113
70. Verwaest C, Verhaegen J, Ferdinande P, Schetz M, van den Berghe G, Verbist L et al. Randomized, controlled trial of selective digestive decontamination in 600 mechanically ventilated patients in a multidisciplinary intensive care unit. Crit Care Med 1997; 25:63-71
71. Wiener J, Itokazu G, Nathan C, Kabins SA, Weinstein RA. A randomized, double-blind, placebo-controlled trial of selective digestive decontamination in a medical-surgical intensive care unit. Clin Infect Dis 1995; 20:861-867
72. Winter R, Humphreys H, Pick A, MacGowan AP, Willatts SM, Speller DC. A controlled trial of selective decontamination of the digestive tract in intensive care and its effect on nosocomial infection. J Antimicrob Chemother 1992; 30:73-77
73. Zobel G, Kuttnig M, Grubbauer HM, Semmelrock HJ, Thiel W. Reduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract. Crit Care Med 1991; 19:1242-1246
74. Zwaveling JH, Maring JK, Klompmaker IJ, Haagsma EB, Bottema JT, Laseur M et al. Selective decontamination of the digestive tract to prevent postoperative infection: a randomized placebo-controlled trial in liver transplant patients. Crit Care Med 2002; 30:1204-1209
75. Lingnau W, Berger J, Javorsky F, Fille M, Allerberger F, Benzer H. Changing bacterial ecology during a five year period of selective intestinal decontamination. J Hosp Infect 1998; 39:195-206
76. Kuipers JS. Combinations of antimicrobial agents. The in-vitro sensitivity of 100 strains of Pseudomonas aeruginosa to polymyxin B, colistin, carbenicillin, gentamicin and doxycycline and to various combinations of theses antibiotics. Archivum Chirurgicum Neerlandicum 1975; 27:257-270
77. Mulder JG, Wiersma WE, Welling GW, van der Waaij D. Low dose oral tobramycin treatment for selective decontamination of the digestive tract: a study in human volunteers. J Antimicrob Chemother 1984; 13:495-504
78. van Saene JJ, van Saene HK, Tarko-Smit NJ, Beukeveld GJ. Enterobacteriaceae suppression by three different oral doses of polymyxin E in human volunteers. Epidemiol Infect 1988; 100:407-417
79. van Saene JJM, Stoutenbeek CP, van Saene HKF et al. Reduction of the intestinal endotoxin pool by three different SDD regimens in human volunteers. J Endotoxin Res 1996; 3:337-343
80. van Saene HKF, Reilly NJ, de Silvestre A et al. Antibiotic policies in the intensive care unit. In: van Saene HKF, Silvestri L, de la Cal MA, eds. Infection Control in the Intensive Care Unit, 2nd ed. Milan, Italy: Springer Verlag 2005. p. 231-246
81. Ledingham IM, Alcock SR, Eastaway AT, McDonald JC, McKay IC, Ramsay G. Triple regimen of selective decontamination of the digestive tract, systemic cefotaxime, and microbiological surveillance for prevention of acquired infection in intensive care. Lancet 1988; 1:785-790
82. Silvestri L, van Saene HKF. Selective decontamination of the digestive tract does not increase resistance in critically ill patients: Evidence from randomised controlled trials. Crit Care Med 2006; 34:2027-2030
83. Hammond JM, Potgieter PD. Long-term effects of selective decontamination on antimicrobial resistance. Crit Care Med 1995; 23:637-645
84. van der Voort PH, van Roon EN, Kampinga GA, Boerma EC, Gerritsen RT, Egbers PH et al. A before-after study of multiresistance and cost of selective decontamination of the digestive tract. Infection 2004; 32:271-277
85. Viviani M, van Saene HK, Dezzoni R, Silvestri L, Di Lenarda R, Berlot G et al. Control of imported methicillin-resistant Staphylococcus aureus (MRSA) on mechanically ventilated patients: a dose-response study of enteral vancomycin to reduce absolute carriage and infection. Anaesth Intensive Care 2005; 33:361-372
86. 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
87. Sarginson RE, Taylor N, Reilly N, Baines PB, van Saene HK. Infection in prolonged pediatric critical illness: A prospective four year study based on knowledge of the carrier state. Crit Care Med 2004; 32:839-847
88. Heininger A, Meyer E, Schwab F, Marschal M, Unertl K, Krueger WA. Effects of long-term routine use of selective digestive decontamination on antimicrobial resistance. Intensive Care Med 2006; 32:1569-1576
89. Leone M, Albanese J, Antonini F, Nguyen-Michel A, Martin C. Long-term (6-year) effect of selective digestive decontamination on antimicrobial resistance in intensive care, multiple-trauma patients. Crit Care Med 2003; 31:2090-2095
90. de la Cal MA, Cerdá E, van Saene HK, García-Hierro P, Negro E, Parra ML et al. Effectiveness and safety of enteral vancomycin to control endemicity of methicillin-resistant Staphylococcus aureus in a medical/surgical intensive care unit. J Hosp Infect 2004; 56:175-183
91. Tetteroo GWM, Wagenvoort JHT, Bruining HA. Bacteriology of selective decontamination: efficacy and rebound colonisation. J Antimicrob Chemother 1994; 34:139-148
92. Cerdá E, Abella A, de la Cal MA, Lorente JA, García-Hierro P, van Saene HK et al. Enteral vancomycin controls methicillinresistant Staphylococcus aureus endemicity in an intensive care burn unit: a 9-year prospective study. Ann Surg 2007; 245:397-407
93. Bonten MJ, van Tiel FH, van der Geest S, Stobberingh EE, Gaillard CA. Enterococcus faecalis pneumonia complicating topical antimicrobial prophylaxis. New Engl J Med 1993; 328:209-210
94. Ebner W, Kropec-Hubner A, Daschner FD. Bacterial resistance and overgrowth due to selective decontamination of the digestive tract. Eur J Clin Microbiol Infect Dis 2000; 19:243-247
95. Kollef MH. Selective digestive decontamination should not be routinely employed. Chest 2003; 123 (5 Suppl):464S-468S
96. Tetteroo GW, Wagenvoort JH, Mulder PG, Ince C, Bruining HA. Decreased mortality rate and length of hospital stay in surgical intensive care unit patients with successful decontamination of the gut. Crit Care Med 1993; 21:1692-1698
97. Dive A, Clavero R, Installe E. Reduced mortality rate with gut decontamination. Crit Care Med 1994; 22:1887-1888
98. Stoutenbeek CP, van Saene HKF. Selective decontamination of the digestive tract. In: Pinsky MR, Dahinaut JF, Artigas A, eds. The Splanchnic Circulation. Berlin: Springer 1995. p. 165-174
99. Kallet RH, Quinn TE. The gastrointestinal tract and ventilator-associated pneumonia. Respir Care 2005; 50:910-921