Selective Decontamination of the Digestive Tract and Prevention of Ventilator-Associated Pneumonia
Authors: Paul Baines, Hendrik van Saene
Journal: Annals of Internal Medicine (2004)

Letters5 October 2004Selective Decontamination of the Digestive Tract and Prevention of Ventilator-Associated PneumoniaPaul Baines, MD and Hendrik van Saene, MDPaul Baines, MDFrom Alder Hey Children's Hospital, Liverpool L12 2AP, United Kingdom.Search for more papers by this author and Hendrik van Saene, MDFrom Alder Hey Children's Hospital, Liverpool L12 2AP, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-7-200410050-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In a response to comments about their evidence-based systematic review (1), Collard and colleagues wrote that “there is ample evidence to suggest that the use of selective decontamination of the digestive tract [SDD] may increase antimicrobial resistance” (2). To support this statement, they cited 2 reviews by Kollef (3) and Ebner and associates (4). Both Kollef and Daschner, one of Ebner's coauthors, have written repeatedly against SDD. A statement based on expert opinion is misleading and runs contrary to the aims of evidence-based medicine: the best estimate based on an impartial review of all available information. Among ...References1. Collard HR, Saint S, Matthay MA. Prevention of ventilator-associated pneumonia: an evidence-based systematic review. Ann Intern Med. 2003;138:494-501. [PMID: 12639084] LinkGoogle Scholar2. Collard HR, Saint S, Matthay MA. Prevention of ventilator-associated pneumonia [Letter]. Ann Intern Med. 2004;140:486-7. LinkGoogle Scholar3. Kollef MH. Selective digestive decontamination should not be routinely employed. Chest. 2003;123:464S-8S. [PMID: 12740230] CrossrefMedlineGoogle Scholar4. Ebner W, Kropec-Hubner A, Daschner FD. Bacterial resistance and overgrowth due to selective decontamination of the digestive tract. Eur J Clin Microbiol Infect Dis. 2000;19:243-7. [PMID: 10834811] CrossrefMedlineGoogle Scholar5. de la Cal MA, Cerda E, van Saene HK, Garcia-Hierro P, Negro E, Parra ML, et al . Effectiveness and safety of enteral vancomycin to control endemicity of methicillin-resistant Staphylococcus aureus in a medical/surgical intensive care unit. J Hosp Infect. 2004;56:175-83. [PMID: 15003664] CrossrefMedlineGoogle Scholar6. Sarginson RE, Taylor N, Reilly N, Baines PB, Van Saene HK. Infection in prolonged pediatric critical illness: A prospective four-year study based on knowledge of the carrier state. Crit Care Med. 2004;32:839-47. [PMID: 15090971] CrossrefMedlineGoogle Scholar7. Liberati A, D'Amico R, Pifferi S, Torri V, Brazzi L. Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev. 2004:CD000022. [PMID: 14973945] MedlineGoogle Scholar8. de Jonge E, Schultz MJ, Spanjaard L, Bossuyt PM, Vroom MB, Dankert J, et al . Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet. 2003;362:1011-6. [PMID: 14522530] CrossrefMedlineGoogle Scholar9. Collard HR, Saint S. Preventive practices for ventilator-associated pneumonia.. In: Shojania KG, Duncan BW, McDonald KM, Wachter RM, eds. Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Evidence Report/Technology Assessment No. 43. Agency for Healthcare Research and Quality publication 01-E058. Rockville, MD: Agency for Healthcare Research and Quality; 2001. Google Scholar Author, Article, and Disclosure InformationAuthors: Paul Baines, MD; Hendrik van Saene, MDAffiliations: From Alder Hey Children's Hospital, Liverpool L12 2AP, United Kingdom. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrevention of Ventilator-Associated Pneumonia: An Evidence-Based Systematic Review Harold R. Collard , Sanjay Saint , and Michael A. Matthay Prevention of Ventilator-Associated Pneumonia Harold R. Collard , Sanjay Saint , and Michael A. Matthay Selective Decontamination of the Digestive Tract and Prevention of Ventilator-Associated Pneumonia Harold R. Collard , Sanjay Saint , and Michael A. Matthay Metrics Cited bySelective decontamination of the digestive tract reduces pneumonia and mortality without resistance emergingDescontaminación digestiva selectiva. ¿Por qué no aplicamos la evidencia en la práctica clínica?Prevention of Infection Using Selective Decontamination of the Digestive TractQuality Management in the ICU: Understanding the Process and Improving the Art 5 October 2004Volume 141, Issue 7Page: 577KeywordsAntibiotic resistanceAntibioticsAntimicrobial resistanceBacteriaDecontaminationGastrointestinal tractIntensive care unitsMethicillin-resistant staphylococcus aureusStaphylococcal infectionSystematic reviews ePublished: 5 October 2004 Issue Published: 5 October 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...