Philosophy of SDD

Abstract

This session highlighted the central issue of SDD: namely, the use of selective antimicrobial chemoprophylaxis for controlling infection by preventing the colonization of high-risk patients by potentially pathogenic microorganisms. Short-term chemoprophylaxis is widely established in medicine for various circumstances; in these cases the drug(s) are selected and systemically targeted against defined pathogenic microorganisms of known or presumed sensitivity, the drugs being administered briefly (e.g. during the perioperative period). SDD differs in that chemoprophylactic agents are administered for a period dictated by the length of the patient’s stay, and in that the need is for drugs which can be administered orally, which are non-absorbable, and which remain stable in the gut and oropharynx and have a broad spectrum of activity against a range of potentially pathogenic microorganisms while sparing the anaerobic flora (which is considered non-pathogenic and important for maintaining the homeostasis of the bowel flora).