The objective of this prospective, randomized, double-blind study was to evaluate the effect of the addition of @entity23782 to the 'classical' topical SDD regimen ( @entity2890 80 mg, @entity3273 100 mg, @entity2379 500 mg) on the development of @entity281 due to gram-positive bacteria. The study was carried out in an intensive care unit (ICU) of a 1400-bed community hospital. All @entity1 admitted to the ICU during a 16-month period, who were expected to require mechanical ventilation for more than 24 hours, were randomized to receive either the 'classical' SDD regimen (Group A) or a modified regimen with @entity23782 (Group B). Data from 223 @entity1 requiring mechanical ventilation for at least 48 hours, who were neither infected nor receiving antibiotics on ICU admission, was analysed. A 2% paste containing @entity2890 , @entity3273 and @entity2379 was applied every 6 hours in the oropharynx to the @entity1 in Group A, while in Group B this formula was modified with the addition of 2% @entity23782 . In Group B 0.2 ml of a 2% @entity23782 ointment was also applied four times daily in both nostrils. @entity1 in Group A received a soft paraffin ointment as a placebo indistinguishable from @entity23782 . @entity1 in both groups received the classic SDD regimen through the nasogastric tube. Systemic antibiotic prophylaxis was not used. Data on lower airway @entity281 , infections of intravascular catheters, antibiotic consumption and expenditures for antibiotics were analysed. The diagnosis of @entity2489 ( @entity2489 ) was based on quantitative cultures of protected specimen brush samples (PSB) or on the results of distal broncho-alveolar lavage (BAL). One hundred and four @entity1 received the 'classical' SDD and 119 the modified regimen. Overall 29 @entity1 , 20 in Group A and nine in Group B (p < 0.02) had a total of 33 cases of @entity55 . There were 23 episodes of @entity55 in Group A and 10 in Group B (p < 0.02). Gram-positive bacteria were isolated from samples in 17 episodes in Group A and six in Group B (p < 0.02). @entity794 was isolated in nine cases of @entity55 in Group A and once in the ' @entity23782 ' group (p < 0.05). @entity794 were isolated in seven out of nine cases in Group A and in the only case in Group B. There were no differences in the isolation of gram-negative bacilli. Antibiotic consumption and cost were lower in Group B. In conclusion, our data show that the topical use of a modified formula of SDD, with the addition of @entity23782 to the oral paste and in the anterior nares, is associated with a @entity358 caused by gram-positives and in a reduction in antibiotic consumption and in the overall expenditure for antibiotics.

Reduction in gram-positive @entity55 and antibiotic consumption following the use of a SDD protocol including nasal and oral XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2890 :: ('MESH:D014031', 'Chemical') :: ['tobramycin'] @entity3273 :: ('MESH:D003091', 'Chemical') :: ['polymyxin E'] @entity2379 :: ('MESH:D000666', 'Chemical') :: ['amphotericin B'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity794 :: ('1280', 'Species') :: ['Staphylococcus aureus', 'MRSA'] @entity281 :: ('MESH:D007239', 'Disease') :: ['ICU-acquired infections', 'infection, and blood infection'] @entity23782 :: ('MESH:D016712', 'Chemical') :: ['mupirocin'] @entity2489 :: ('MESH:D053717', 'Disease') :: ['ventilator-associated pneumonia', 'VAP'] @entity358 :: ('MESH:D008171', 'Disease') :: ['reduction in lung infections']
@entity23782 :: (MESH:D016712,Chemical) :: ['mupirocin']
