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Infection Prevention in the ICU by Selective Decontamination of the Digestive Tract with Topical Nonabsorbable Antibiotics

  • C. P. Stoutenbeek
  • H. K. F. van Saene
  • D. F. Zandstra
Part of the Klinische Anästhesiologie und Intensivtherapie book series (KAI, volume 36)

Abstract

Infection continues to be a major problem in the Intensive Care Unit (ICU). In the past ten years the infection rate is essentially unchanged. The high infection rate is explained by a combination of several factors:
  1. 1.

    ICU-patients have an impaired infection defence;

     
  2. 2.

    the use of invasive techniques for monitoring and support;

     
  3. 3.

    crowding healthy and colonized or infected patients in a relatively small area, where patients are subjected to multiple manipulations by the same personnel.

     

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References

  1. 1.
    HAZENBERG, M. P., BOOM VAN DE, M., BAKKER, M., MERWE VAN DER, J. P.: Effect of antibiotics on the human intestinal flora in mice. Antonie Van Leeuwenhoek 49, 97 (1983)Google Scholar
  2. 2.
    HAZENBERG, M. P., PENNOCK-SCHROEDER, A. M., MERWE VAN DER, J. P.: Binding to and antibacterial effect of aztreonam, temocillin, gentamicin and tobramycin on human faeces. J. Hyg. Camb. 95, 255 (1985)PubMedCrossRefGoogle Scholar
  3. 3.
    LAMBERT-ZECHOVSKY, N., AUFRANT, C., BINGEN, E., BLUM, C., PROUX, M. C., MATHIEU, H.: Cefotaxime in children: efficacy, tolerance and effect on the intestinal bacterial flora. J. antimicrob. Chemother. 6, 235 (1980)PubMedGoogle Scholar
  4. 4.
    NORTHEY, D., ADESS, M. L., HARTSUCK, J. M., RHOADES, E. R.: Microbial surveillance in a surgical intensive care unit. Surg. Gynec. Obstet. 139, 321 (1974)Google Scholar
  5. 5.
    SAENE VAN, J. J. M., SAENE VAN, H. K. F., STOUTENBEEK, C. P., LERK, C. F.: Influence of faeces on the activity of antimicrobial agents used for decontamination of the alimentary canal. Scand. J. infect. Dis. 17, 295 (1985)PubMedGoogle Scholar
  6. 6.
    SOGAARD, H.: The pharmacodynamics of polymyxin antibiotics with special reference to drug resistance liability. J. vet. Pharmacol. Ther. 5, 219 (1982)PubMedCrossRefGoogle Scholar
  7. 7.
    STOUTENBEEK, C. P., SAENE VAN, H. K. F., MIRANDA, D. R., ZANDSTRA, D. F.: The effect of selective decontamination of the digestive tract on colonisation and infection in multiple trauma patients. Intens. Care Med. 10, 185 (1984)CrossRefGoogle Scholar
  8. 8.
    STOUTENBEEK, C. P., SAENE VAN, H. K. F., MIRANDA, D. R., ZANDSTRA, D. F., BINNENDIJK, B.: A novel approach to antibiotic prophylaxis in multiple trauma patients. In: Infections en milieu chirurgicale (ed. P. VIAR), p. 381. Librairie Arnette 1985Google Scholar
  9. 9.
    STOUTENBEEK, C. P., SAENE VAN, H. K. F., MIRANDA, D. R., ZANDSTRA, D. F., LANGREHR, D.: The effect of oropharyngeal decontamination using topical non-absorbable antibiotics on the incidence of nosocomial respiratory tract infections in multiple trauma patients. J. Trauma (In press)Google Scholar
  10. 10.
    STOUTENBEEK, C. P., SAENE VAN, H. K. F., MIRANDA, D. R., ZANDSTRA, D. F., LANGREHR, D.: Nosocomial gram-negative pneumonia in critically ill patients. A 3-year experience with a novel therapeutic regimen. Intens. Care Med. 12, 419 (1986)Google Scholar
  11. 11.
    STOUTENBEEK, C. P., SAENE VAN, H. K. F., ZANDSTRA, D. F.: Effect of oral nonabsorbable antibiotics on the emergence of resistance in ICU patients. J. antimicrob. Chemother. 19, 513 (1987)PubMedCrossRefGoogle Scholar
  12. 12.
    THORP, J. M., RICHARDS, W. C., TELFER, A. B.: A survey of infection in an intensive care unit. “Forwarned is forarmed”. Anaesthesia 34, 643 (1979)PubMedCrossRefGoogle Scholar
  13. 13.
    WAAIJ VAN DER, D., BERGHUIS-DE VRIES, J. M., LEKKERKERK VAN DER, J. E. C.: Colonization resistance of the digestive tract in conventional and antibiotic-treated mice. J. Hyg. Carob. 69, 405 (1971)CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • C. P. Stoutenbeek
  • H. K. F. van Saene
  • D. F. Zandstra

There are no affiliations available

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