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Selective decontamination of the digestive tract in intensive care Boom SJ; Ramsay GEpidemiol Infect 1992[Dec]; 109 (3): 337-47Nosocomial infection in intensive care unit (ICU) practice is a common problem and is associated with abnormal carriage of Gram-negative aerobic bacilli in the gastrointestinal tract, resulting in endogenous infections. Selective decontamination of the digestive tract (SDD) is a regimen aimed at preventing or eradicating this abnormal carriage. A large number of trials examining SDD in ICU practice have been published, the vast majority showing a significant reduction in the incidence of nosocomial, Gram-negative infection. However, the impact on morbidity and mortality is much less certain. A recent meta-analysis has suggested a 10-20% reduction in mortality (3-6% absolute difference) with SDD. A discussion of these results is presented together with potential criticisms of SDD.|Anti-Bacterial Agents/therapeutic use[MESH]|Clinical Trials as Topic[MESH]|Critical Care/*methods[MESH]|Cross Infection/drug therapy/*prevention & control[MESH]|Digestive System/*microbiology[MESH]|Gram-Negative Bacterial Infections/drug therapy/*prevention & control[MESH]|Humans[MESH] |
