Anest. intenziv. Med. 2008;19(5):260-268

Twenty five years of selective digestion decontamination - the questions remain unansweredIntesive Care Medicine - Review Article

Kratochvíl Milan*, Ševčík Pavel
Klinika anesteziologie, resuscitace a intenzivní medicíny FN Brno a LF MU Brno

Selective digestive decontamination in intensive care is a part of the preventive antimicrobial measures expected to make a positive contribution to the infection prevention, treatment, epidemiology and economy of ICUs. Since its origination it has been used in a limited number of centers reporting many positive results. A wider spread of the method has been thwarted by its not always conclusive and encouraging results and especially fears of promoting antimicrobial resistance which originate in the currently accepted restrictive antibiotic policy. According to this policy, antibiotic prophylaxis in general is not only ineffective but may also produce increased prevalence of multi-restistant bacteria. Our review offers pathophysiologic principles of selective digestive decontamintation, different aspects of its effect and the opinions of the present-day promoters and opponents of the method. Even in the 25 years since it was brougt into practice in intensive care, the verdict about its place in the hospital-acquired infection prevention remains open.

Keywords: selective digestive decontamination; secondary endogenous infections; infection prevention; antibiotic resistance; ventilator-associated pneumonia

Received: May 12, 2008; Accepted: August 20, 2008; Published: October 1, 2008  Show citation

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Kratochvíl M, Ševčík P. Twenty five years of selective digestion decontamination - the questions remain unanswered. Anest. intenziv. Med. 2008;19(5):260-268.
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