Selective decontamination of digestive tract in intensive care patients leads to fewer in-hospital deaths

Christopher S. Hollenbeak, David K. Warren

Research output: Contribution to journalComment/debate

Abstract

Question. Does selective decontamination of the digestive tract (SDD) of people in intensive care (ICU) reduce mortality and infection by drug-resistant bacteria? Study design. Unblinded randomised controlled trial. Main results. In the ICU, SDD lowered mortality compared with usual care (69 deaths vs. 107 deaths; RR 0.65 95% CI 0.49-0.85, p=0.002). SDD decreased overall hospital mortality compared with usual care (113 vs. 146; p = 0.02). Acquired infections of resistant Gram-negative aerobic bacteria were lower for SDD compared with usual care (16% vs. 26%, RR 0.61, 95% CI 0.46-0.81). There were no differences in vancomycin-resistant enterococcus infections between groups (p = 1.0). No methicillin-resistant S. aureus were found in either group. The usual care unit was colonised with significantly more ceftazidime-resistant enterobacteriaceae compared with the SDD unit (p < 0.0001). This was the only significant difference in bacterial colonisation between units. Authors' conclusions. SDD decreased colonisation with vancomycin-resistant enterococcus, and reduced in-hospital mortality.

Original languageEnglish (US)
Pages (from-to)107-109
Number of pages3
JournalEvidence-Based Healthcare
Volume8
Issue number2
DOIs
StatePublished - Jan 1 2004

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Decontamination
Critical Care
Gastrointestinal Tract
Hospital Mortality
Gram-Negative Aerobic Bacteria
Infection
Methicillin Resistance
Ceftazidime
Mortality
Enterobacteriaceae
Randomized Controlled Trials
Bacteria
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Selective decontamination of digestive tract in intensive care patients leads to fewer in-hospital deaths",
abstract = "Question. Does selective decontamination of the digestive tract (SDD) of people in intensive care (ICU) reduce mortality and infection by drug-resistant bacteria? Study design. Unblinded randomised controlled trial. Main results. In the ICU, SDD lowered mortality compared with usual care (69 deaths vs. 107 deaths; RR 0.65 95{\%} CI 0.49-0.85, p=0.002). SDD decreased overall hospital mortality compared with usual care (113 vs. 146; p = 0.02). Acquired infections of resistant Gram-negative aerobic bacteria were lower for SDD compared with usual care (16{\%} vs. 26{\%}, RR 0.61, 95{\%} CI 0.46-0.81). There were no differences in vancomycin-resistant enterococcus infections between groups (p = 1.0). No methicillin-resistant S. aureus were found in either group. The usual care unit was colonised with significantly more ceftazidime-resistant enterobacteriaceae compared with the SDD unit (p < 0.0001). This was the only significant difference in bacterial colonisation between units. Authors' conclusions. SDD decreased colonisation with vancomycin-resistant enterococcus, and reduced in-hospital mortality.",
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Selective decontamination of digestive tract in intensive care patients leads to fewer in-hospital deaths. / Hollenbeak, Christopher S.; Warren, David K.

In: Evidence-Based Healthcare, Vol. 8, No. 2, 01.01.2004, p. 107-109.

Research output: Contribution to journalComment/debate

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AU - Warren, David K.

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N2 - Question. Does selective decontamination of the digestive tract (SDD) of people in intensive care (ICU) reduce mortality and infection by drug-resistant bacteria? Study design. Unblinded randomised controlled trial. Main results. In the ICU, SDD lowered mortality compared with usual care (69 deaths vs. 107 deaths; RR 0.65 95% CI 0.49-0.85, p=0.002). SDD decreased overall hospital mortality compared with usual care (113 vs. 146; p = 0.02). Acquired infections of resistant Gram-negative aerobic bacteria were lower for SDD compared with usual care (16% vs. 26%, RR 0.61, 95% CI 0.46-0.81). There were no differences in vancomycin-resistant enterococcus infections between groups (p = 1.0). No methicillin-resistant S. aureus were found in either group. The usual care unit was colonised with significantly more ceftazidime-resistant enterobacteriaceae compared with the SDD unit (p < 0.0001). This was the only significant difference in bacterial colonisation between units. Authors' conclusions. SDD decreased colonisation with vancomycin-resistant enterococcus, and reduced in-hospital mortality.

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