Skip to main content
SpringerLink
Log in

Selective Decontamination of the Digestive Tract

  • Chapter
The Splanchnic Circulation

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 23))

Abstract

The conventional classification of hospital infections is into community-acquired and nosocomial infections, the latter referring to infections developing after 48 h following admission to the hospital. A further period of 48 h is commonly used to distinguish between intensive care unit (ICU)-acquired infections and infections incubating after admission to the ICU (primary infections). Primary infections may thus be either nosocomial or community acquired, for example, in trauma patients admitted directly to the ICU without prior hospital admission.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Selective Decontamination of the Digestive Tract Trialists' Collaborative Group (1993) Meta-analysis of randomised controlled trials of selective decontamination of the digestive tract. Br Med J 307:525–532

    Article  Google Scholar 

  2. Heyland DK, Cook DJ, Jaeschke R, Griffith L, Lee HN, Guyatt GH (1994) Selective decontamination of the digestive tract: an overview. Chest 105:1221–1229

    Article  PubMed  CAS  Google Scholar 

  3. Koleff MH (1994) The role of selective digestive tract decontamination on mortality and respiratory tract infections. A meta-analysis. Chest 105:1101–1108

    Article  Google Scholar 

  4. Tetteroo GWM, Wagenvoort JHT, Mulder PGH, Ince C, Bruining HA (1993) Decreased mortality rate and length of stay in surgical intensive care unit patients with successful selective decontamination of the gut. Crit Care Med 21:1692–1698

    Article  PubMed  CAS  Google Scholar 

  5. Stoutenbeek CP, van Saene HKF, Miranda DR, Zandstra DF (1984) The effect of selective decontamination of the digestive tract on colonization and infection rate in multiple trauma patients. Intensive Care Med 10:185–192

    Article  PubMed  CAS  Google Scholar 

  6. Feron B, Adair C, Gorman SP, McClurg B (1993) Interaction of sucralfate with antibiotics used for selective decontamination of the gastrointestinal tract. Am J Hosp Pharm 50:2550–2553

    PubMed  CAS  Google Scholar 

  7. Langer M, Cigada M, Mandelli M et al (1987) Early onset pneumonia: a multicenter study in intensive care units. Intensive Care Med 13:342–346

    Article  PubMed  CAS  Google Scholar 

  8. VandenBroucke-Grauls CMJE, VandenBroucke JP (1991) Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in the intensive care units. Lancet 338:859–862

    Article  PubMed  CAS  Google Scholar 

  9. Brun Buisson C (1994) Selective decontamination in critical care. Interpreting the synthesized evidence (editorial). Chest 105:978–980

    Article  PubMed  CAS  Google Scholar 

  10. Ferrer M, Torres A, Gonzalez J, Puig de la Bellacasa J, Gatell JM, Jiménez MT (1992) Utility of selective digestive decontamination in a general population of mechanically ventilated patients. Am Rev Respir Dis 145:A112

    Google Scholar 

  11. Hammond JMJ, Potgieter PD, Saunders GL et al (1992) Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet 340:5–9

    Article  PubMed  CAS  Google Scholar 

  12. Bonten MJM, Gaillard CA, Johanson WG et al (1994) Colonization in patients receiving and not-receiving topical antimicrobial prophylaxis. Am J Respir Gul Care Med 150:1332–1340

    CAS  Google Scholar 

  13. Pugin J, Auckenthaler R, Lew DP, Suter PM (1991) Oropharyngeal decontamination decreases incidence of ventilator associated pneumonia. JAMA 265:2704–2710

    Article  PubMed  CAS  Google Scholar 

  14. Gastinne H, Wolff M, Delatour F et al (1992) A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. N Engl J Med 326:594–599

    Article  PubMed  CAS  Google Scholar 

  15. Tetteroo GWM, Wagenvoort JHT, Castelein AL, Tilanus HW, Ince C, Bruining HA (1990) Selective decontamination to reduce Gram-negative colonization and infection after oesophageal resection. Lancet 335:704–707

    Article  PubMed  CAS  Google Scholar 

  16. Wiesner RH, Krom RAF, Hermans P (1988) Selective bowel decontamination to decrease gram-negative aerobic bacterial and candida colonization and prevent infection after orthotopic liver transplantation. Transplantation 45:570–574

    Article  PubMed  CAS  Google Scholar 

  17. Bion JF, Badger I, Crosby HA et al (1994) Selective decontamination of the digestive tract reduces Gram-negative pulmonary colonization but not sytemic endotoxemia in patients undergoing elective liver transplantation. Crit Care Med 22:40–49

    PubMed  CAS  Google Scholar 

  18. Smith SD, Jackson RJ, Hannakan CJ, Wadowsky RM, Tzakis AG, Rowe MI (1993) Selective decontamination in pediatric liver transplants.Transplantation 55:1306–1309

    Article  PubMed  CAS  Google Scholar 

  19. Rolando N, Gimson A, Wade J, Philpott-Howard J, Casewell M, Williams R (1993) Prospective controlled trial of selective parenteral and enteral antimicrobial regimen in fulminant liver failure. Hepatology 17:196–201

    Article  PubMed  CAS  Google Scholar 

  20. Salmerón JM, Tito L, Rimóla A et al (1992) selective decontamination of the digestive tract in the prevention of bacterial infection in patients with acute liver failure. J Hepatol 14:280–285

    Google Scholar 

  21. Mackie DP, van Hertum WAJ, Schumburg T, Kuijper EC, Knape P (1992) Prevention of infection in burns: preliminary experience with selective decontamination of the digestive tract in patients with extensive injuries. J Trauma 32:570–575

    Article  PubMed  CAS  Google Scholar 

  22. Manson WL, Pernot PCJ, Fidler V, Sauer EW, Klasen HJ (1992) Colonization of burns and the duration of hospital stay of severely burned patients. J Hosp Infect 22:55–63

    Article  PubMed  CAS  Google Scholar 

  23. Rocha L A, Martin MJ, Pita S et al (1992) 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 18:398–404

    Article  PubMed  CAS  Google Scholar 

  24. Nardi G, Valentis U, Proietti A et al (1993) Epidemiological impact of prolonged systematic use of topical SDD on bacterial colonization of the tracheobronchial tree and antibiotic resistance. Intensive Care Med 19:273–288

    Article  PubMed  CAS  Google Scholar 

  25. Hammond JMJ, Potgieter PD (1995) Long-term effects of selective decontamination on antimicrobial resistance. Gul Care Med 23:637–645

    Article  CAS  Google Scholar 

  26. Humphreys H, Winter R, Pick A (1992) The effect of selective decontamination of the digestive tract on gastrointestinal enterococcal colonization in ITU patients. Intensive Care Med 18:459–463

    Article  PubMed  CAS  Google Scholar 

  27. Verhaegen J (1992) Randomized study of selective digestive decontamination on colonisation and prevention of infections in mechanically ventilated patients in the ICU. Thesis

    Google Scholar 

  28. LeuvenCockerill FR, Muller SM, Anhalt JP et al (1992) Prevention of infection in critically ill patients by selective decontamination of the digestive tract. Ann Intern Med 117:545–553

    Google Scholar 

  29. Aerdts SJ, van Dalen R, Clasener HAL, Festen J, van Lier HJJ, Vollaard EJ (1991) Antibiotic prophylaxis of respiratory tract infections in mechanically ventilated patients. A prospective, blinded, randomized trial of the effect of a novel regimen. Chest 100:783–791

    Article  PubMed  CAS  Google Scholar 

  30. Ulrich C, Harinck-de Weerd JE, Bakker NC, Jacz K, Doornbos L, de Ridder VA (1990) Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study. Intensive Care Med 15:424–431

    Google Scholar 

  31. Palomar M (1991) Prevention of nosocomial pneumonia in ventilated patients using cefotaxime (CTX) and SDD. 17th international congress on chemotherapy, Berlin

    Google Scholar 

  32. Blair P, Rowlands BJ, Lowry K, Webb H, Armstrong P, Smilie J (1991) Selective decontamination of the digestive tract: a stratified, randomized, prospective study in a mixed intensive care unit. Surgery 110:303–310

    PubMed  CAS  Google Scholar 

  33. Kerver AJH, Rommes JH, Verhage EAE (1988) Prevention of colonization and subsequent infection in surgical intensive care patients. A prospective randomized study. Crit Care Med 16:1087–1093

    Article  PubMed  CAS  Google Scholar 

  34. Jacobs S, Foweraker JE, Roberts SE (1992) Effectiveness of selective decontamination of the digestive tract (SDD) in an ICU with a policy encouraging a low gastric pH. Clin Intensive Care 3:52–58

    Google Scholar 

  35. Sanchez M, Lopez J, Galvan B, Calvo C, Nunez A, Cambronero JA, Alvarez J, Rogero S, Chamorro C, Rodriguez JM, Guerra L, Rubio J, Cerdâ E (1990) Selective digestive tract decontamination (SDD) and sucralfate (S) in intubated patients. Intensive Care Med 16:S32 (abstract)

    Google Scholar 

  36. Winter R, Humphreys H, Pick A, MacGowan AP, Willatts SM, Speller DCE (1992) A controlled trial of selective decontamination of the digestive tract in intensive care and its effect on nosocomial infection. J Antimicrob Chemother 30:73–87

    Article  PubMed  CAS  Google Scholar 

  37. Korinek AM, Laisne MJ, Nicolas MH, Raskine L, Deroin V, Sanson-Lepors MJ (1993) Selective decontamination of the digestive tract in neurosurgical intensive care unit patients: a double blind, randomized, placebo-controlled study. Crit Care Med 21:1466–1473

    Article  PubMed  CAS  Google Scholar 

  38. Cerra FB, Maddaus MA, Dunn DL, Wells CL, Konstantinides NN, Lehmann SL, Mann HJ (1992) Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients. Arch Surg 127:163–169

    PubMed  CAS  Google Scholar 

  39. Godard J, Guillaume C, Reverdy ME, Bachmann P, Bui-Xuan B, Nageotte A, Motin J (1990) Intestinal decontamination in a polyvalent ICU: a double-blind study. Intensive Care Med 16:307–311

    Article  PubMed  CAS  Google Scholar 

  40. Unertl K, Ruckdeschel G, Selbmann HK, Jensen U, Forst H, Lenhardt FP, Peter K (1987) Prevention of colonization and respiratory infections in longterm ventilated patients by local antimicrobial prophylaxis. Intensive Care Med 13:106–113

    Article  PubMed  CAS  Google Scholar 

  41. Gaussorgues P, Salord F, Sirodot M, Tigaud S, Cagnin S, Gerard M, Robert D (1991) Efficacité de la décontamination digestive sur la survenue des bactériémies nosocomials chez les patients sous ventilation mécanique et recevant des bêtamimétiques. Rean Soins Intens Med Urg 7:169–174

    Google Scholar 

  42. Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A, Carillo A, Garcia J, Leon J, Marti- nez-Pellus AJ (1990) Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med 18:1239–1242

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. C. P. Stoutenbeek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. K. Fvan Saene
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Dept. of Anesthesiology and Critical Care Medicine, University of Pittsburgh, 604 Scaife Hall, 15261, Pittsburgh, PA, USA

    Michael R. Pinsky

  2. Clinical Pharmacology and Critical Care Medicine, Cochin Port-Royal University Hospital, 27 rue du Faubourg St. Jaques, F-75679, Paris, France

    Jean-Francois Dhainaut

  3. Servei des Medicina Intensiva Parc Tauli, Consorci Hospitalari Parc Tauli, E-08208, Sabadell, Spain

    Antonio Artigas

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Stoutenbeek, C.P., Fvan Saene, H.K. (1995). Selective Decontamination of the Digestive Tract. In: Pinsky, M.R., Dhainaut, JF., Artigas, A. (eds) The Splanchnic Circulation. Update in Intensive Care and Emergency Medicine, vol 23. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79715-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-79715-6_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79717-0

  • Online ISBN: 978-3-642-79715-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation