Selective decontamination

Selective digestive decontamination is superior to selective oropharyngeal decontamination

are interested in the debate on the effi cacy and safety of selective digestive decontamination (SDD) and selective oropharyngeal decontamination (SOD) raised by Schultz and Haas in their review [1]. Th e authors concluded that 'SDD and SOD are equally eff ective with respect to the prevention of mortality' [1]. Th is statement is based on the results of a Dutch randomized controlled trial [2],...

Selective decontamination of the gut.

Selective decontamination: no oracle needed

We read with interest the study by Cuthbertson and colleagues [1] in a recent issue of Critical Care, and we appreciate their attempts to support studies regarding selective decontamination of the digestive tract (SDD). However, we have some concerns. The argument supporting a randomized controlled trial (RCT) for the evaluation of SDD is ambiguous. The Delphi method embraces ‘quasi-anonymity’,...

Selective decontamination and antibiotic resistance in ICUs

Selective digestive decontamination (SDD) and selective oropharyngeal decontamination (SOD) have been associated with reduced mortality and lower ICU-acquired bacteremia and ventilator-associated pneumonia rates in areas with low levels of antibiotic resistance. However, the effect of selective decontamination (SDD/SOD) in areas where multidrug-resistant Gram-negative bacteria are endemic is le...

Cystic fibrosis, Pseudomonas aeruginosa, and selective decontamination.

We used an oral topical antibiotic preparation to try and prevent oropharyngeal carriage of Pseudomonas aeruginosa in patients with cystic fibrosis. Ten of 15 patients treated with a two week course of intravenous ceftazidime together with a 90 day course of an antibiotic containing gel continued to carry P aeruginosa in the oropharynx.