Selective decontamination of the digestive tract (SDD): is the game worth the candle?

Abstract:

:Selective decontamination of the digestive tract (SDD) is an infection prevention strategy in intensive care unit (ICU) patients by topical administration of antibiotics to the mouth and stomach to eradicate potentially pathogenic bacteria and yeast that may cause infections. It also includes a short course of intravenous antibiotics to treat incubating infections at the time of ICU admission. Several randomized, controlled studies, all performed in ICUs with low rates of antibiotic resistance, have shown that SDD prevents ventilator-associated pneumonia and improves survival. Surprisingly, SDD was also associated with lower rates of colonization with resistant gram-negative bacteria and no effect on methicillin-resistant STAPHYLOCOCCUS AUREUS (MRSA) and vancomycin-resistant enterococci (VRE). Selective oral decontamination (SOD) consisting of oral antibiotics only, without systemic antibiotics or antibiotics given in the stomach, may also increase survival. In areas with low prevalence of MRSA and VRE, SDD should be considered the standard of care in ICUs. In countries where colonization with MRSA and VRE is frequent, resistance may increase, and SDD should be considered experimental therapy. Future research should focus on the effects of SDD compared with SOD on resistance and on SDD-like strategies in areas where MRSA and VRE are endemic.

authors

van Essen EH,de Jonge E

doi

10.1055/s-0031-1275536

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

236-42

issue

2

eissn

1069-3424

issn

1098-9048

journal_volume

32

pub_type

杂志文章,评审
  • Pulmonary paracoccidioidomycosis.

    abstract::Paracoccidioidomycosis (formerly known as South American blastomycosis) is produced by the thermally dimorphic fungus Paracoccidioides brasiliensis. Most often this mycosis runs a chronic progressive course affecting preferentially the lungs followed by the skin, mucous membranes, adrenals, and reticuloendothelial org...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-2008-1063857

    authors: Restrepo A,Benard G,de Castro CC,Agudelo CA,Tobón AM

    更新日期:2008-04-01 00:00:00

  • Nonspecific interstitial pneumonia (NSIP).

    abstract::Nonspecific interstitial pneumonia (NSIP) represents one histologic subtype of idiopathic interstitial pneumonia (IIP). NSIP is typified by temporal homogeneity and less profusion of fibroblastic foci than is seen with usual interstitial pneumonia (UIP), the most common IIP. Clinically patients with NSIP present with ...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-2001-17385

    authors: Flaherty KR,Martinez FJ,Travis W,Lynch JP 3rd

    更新日期:2001-08-01 00:00:00

  • Treatment of Mycobacterium avium Complex (MAC).

    abstract::Mycobacterium avium complex (MAC) is the most commonly isolated nontuberculous mycobacterial respiratory pathogen worldwide. MAC lung disease is manifested either by fibrocavitary radiographic changes similar to pulmonary tuberculosis or by bronchiectasis with nodular and reticulonodular radiographic changes. This lat...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0038-1660472

    authors: Griffith DE

    更新日期:2018-06-01 00:00:00

  • Artificial Intelligence in the Intensive Care Unit.

    abstract::The diffusion of electronic health records collecting large amount of clinical, monitoring, and laboratory data produced by intensive care units (ICUs) is the natural terrain for the application of artificial intelligence (AI). AI has a broad definition, encompassing computer vision, natural language processing, and m...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-0040-1719037

    authors: Greco M,Caruso PF,Cecconi M

    更新日期:2021-02-01 00:00:00

  • Malignant Mesothelioma: Has Anything Changed?

    abstract::Malignant pleural mesothelioma is a rare cancer associated with asbestos exposure and portends a dismal prognosis. Its worldwide incidence has been increasing, and treatment options are currently suboptimal and noncurative. However, since the turn of the century, several encouraging steps have been made toward improvi...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0039-1693406

    authors: Kim RY,Sterman DH,Haas AR

    更新日期:2019-06-01 00:00:00

  • Nonspecific Interstitial Pneumonia.

    abstract::Nonspecific interstitial pneumonia (NSIP) is a complex disorder commonly associated with other conditions such as connective tissue diseases (CTDs) and environmental exposures. Although idiopathic NSIP has been recognized as a separate clinical entity, recent studies have suggested that a proportion of these cases hav...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-0040-1708499

    authors: Teoh AKY,Corte TJ

    更新日期:2020-04-01 00:00:00

  • Invasive Mechanical Ventilation in Chronic Obstructive Pulmonary Disease Exacerbations.

    abstract::Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality, and health care costs worldwide. Although there exist some heterogeneity between patients, the course of COPD is characterized by recurrent acute exacerbations, which are among the most common causes of medical adm...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-0040-1714396

    authors: Peñuelas Ó,Frutos-Vivar F,Mancebo J

    更新日期:2020-12-01 00:00:00

  • Aspirin-exacerbated respiratory disease: update on pathogenesis and desensitization.

    abstract::Aspirin-exacerbated respiratory disease (AERD) is a unique syndrome of airway inflammation that frequently occurs in patients with nasal polyposis, chronic sinusitis, and asthma. These patients tend to have progressive and recalcitrant sinus disease requiring frequent surgical intervention and in many cases systemic c...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-0032-1325618

    authors: White AA,Stevenson DD

    更新日期:2012-12-01 00:00:00

  • Thoracic applications of dual energy.

    abstract::Computed tomography (CT) is the core imaging modality for the evaluation of thoracic disorders. With the recently developed dual-energy CT (DECT) technique, the clinical utility of CT in the management of pulmonary diseases can be expanded. The most actively investigated principle of dual energy is material decomposit...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0033-1363452

    authors: Remy-Jardin M,Faivre JB,Pontana F,Molinari F,Tacelli N,Remy J

    更新日期:2014-02-01 00:00:00

  • Selected controversies in cardiopulmonary resuscitation.

    abstract::Cardiopulmonary resuscitation (CPR) is performed frequently by paramedics, emergency department personnel, and inpatient physicians. Unfortunately, after more than 40 years of practice and study, there are still many controversies and unresolved treatment issues. This article focuses on four current controversies in C...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-2001-13839

    authors: White SJ,Himes D,Rouhani M,Slovis CM

    更新日期:2001-01-01 00:00:00

  • Coccidioidomycosis: Recent Updates.

    abstract::Coccidioidomycosis manifests as a variety of clinical manifestations and ranges in severity from asymptomatic exposure with resultant immunity to reinfection, to fulminant, and life-threatening disseminated disease. Primary coccidioidal pneumonia represents the most common clinical form of infection, and the incidence...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0035-1562900

    authors: Twarog M,Thompson GR 3rd

    更新日期:2015-10-01 00:00:00

  • Invasive Candidiasis.

    abstract::Invasive candidiasis (IC) is the most frequent health care associated invasive fungal infection. It is also associated with high morbidity, mortality, and cost. The most frequent etiologic agent is Candida albicans, but non-albicans species are increasing and associated with reduced antifungal susceptibility and outbr...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0040-1701215

    authors: Gonzalez-Lara MF,Ostrosky-Zeichner L

    更新日期:2020-02-01 00:00:00

  • Epidemiology of sarcoidosis: recent advances and future prospects.

    abstract::Sarcoidosis is by definition a disease of "unknown causes," but recent epidemiologic advances suggest that the long-standing definition of sarcoidosis may soon need to be amended. The recently completed ACCESS (A Case-Control Etiologic Study of Sarcoidosis) study was not able to definitively identify the "cause" of sa...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-2007-970331

    authors: Rybicki BA,Iannuzzi MC

    更新日期:2007-02-01 00:00:00

  • The status of gene therapy for cystic fibrosis.

    abstract::Cystic fibrosis (CF) has been a primary focus for gene therapy of lung diseases because the genetic cause is known and the airway epithelium is accessible for direct deoxyribonucleic acid (DNA) delivery. Soon after the mutated gene was identified in 1989, investigators demonstrated that transfer of a normal copy of th...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-2004-815670

    authors: Weiss DJ,Pilewski JM

    更新日期:2003-12-01 00:00:00

  • Hematologic failure.

    abstract::Hematologic factors, in particular platelets and the coagulation system, play an important role in the pathogenesis of organ failure in the intensive care unit. Failure of these hematologic systems is common in intensive care patients and may range from isolated thrombocytopenia or prolonged global clotting tests to c...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0031-1287873

    authors: Levi M,Schultz M

    更新日期:2011-10-01 00:00:00

  • Pandemic (avian) influenza.

    abstract::Pandemics of influenza have been reported since the early sixteenth century. Recent pandemics include the Spanish flu (H1N1) from 1918 to 1920 (resulting in approximately 50 million deaths worldwide); the Asian flu (H2N2) from 1957 to 1958 (resulting in more than 1 million deaths); the Hong Kong flu (H3N2) from 1968 t...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-2007-976488

    authors: Rajagopal S,Treanor J

    更新日期:2007-04-01 00:00:00

  • Usual interstitial pneumonia.

    abstract::Usual interstitial pneumonia (UIP) is a distinct histological lesion observed in idiopathic pulmonary fibrosis (IPF) but can be found in other etiologies. The diagnosis of UIP can be established by surgical lung biopsy or by high-resolution thin-section computed tomographic (CT) scans (provided the radiographic featur...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-2006-957335

    authors: Lynch JP 3rd,Saggar R,Weigt SS,Zisman DA,White ES

    更新日期:2006-12-01 00:00:00

  • Pulmonary manifestations of rheumatoid arthritis.

    abstract::Rheumatoid arthritis (RA) is a systemic disease, characterized by symmetric joint involvement, but it can also affect other organ systems, including the lungs. The better-known pulmonary manifestations of RA are interstitial lung disease, rheumatoid nodules, and pleural effusions. Less common manifestations include br...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-2007-985664

    authors: Gauhar UA,Gaffo AL,Alarcón GS

    更新日期:2007-08-01 00:00:00

  • Invasive fungal infections in the intensive care unit.

    abstract::Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in intensive care. Patients who are critically ill, in medical or surgical ICUs are especially at risk for CANDID...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-0029-1246289

    authors: Vazquez JA

    更新日期:2010-02-01 00:00:00

  • DNA viruses (CMV, EBV, and the herpesviruses).

    abstract::The human Herpesviridae family consists of eight members: cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus 1 and 2 (HSV-1, -2), varicella-zoster virus (VZV), and human herpesvirus 6, 7, and 8 (HHV-6, -7, -8). Lifelong latency may develop in the host with reactivation during periods of relative imm...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0031-1283285

    authors: Zamora MR

    更新日期:2011-08-01 00:00:00

  • The diagnostic approach to deep venous thrombosis.

    abstract::Accurate diagnosis of deep vein thrombosis is important because untreated deep vein thrombosis can cause death or permanent impairment and because effective treatments are available. The approach to the diagnosis of deep vein thrombosis varies because of differences in local resources and expertise. Duplex ultrasonogr...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-2000-13187

    authors: Elliott CG

    更新日期:2000-01-01 00:00:00

  • The role of corticosteroids in chronic obstructive pulmonary disease.

    abstract::Oral corticosteroids are powerful relatively nonspecific antiinflammatory agents with a range of well-characterized side effects. There is good evidence to show that they accelerate the rate of resolution of exacerbations of COPD and relapse is less likely if patients receive these drugs. Maintenance therapy with oral...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-2005-869542

    authors: Calverley PM

    更新日期:2005-04-01 00:00:00

  • Mycobacterial infections caused by nontuberculous mycobacteria.

    abstract::The purpose of this review is to familiarize a broad range of medical professionals with a relatively new and growing problem of infections caused by mycobacteria other than M. tuberculosis and M. leprae. There are at least 60 mycobacterial species that have been identified as causative agents of diseases in humans. T...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1055/s-2004-829501

    authors: Heifets L

    更新日期:2004-06-01 00:00:00

  • Medical therapy of sarcoidosis.

    abstract::For treatment of sarcoidosis, one should develop a long-term management plan. Factors to be considered include the organ involvement and severity of symptoms. Different organ manifestations may require different treatments. Intensity of treatment is usually based on severity of disease or potential for organ failure o...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0034-1376401

    authors: Baughman RP,Lower EE

    更新日期:2014-06-01 00:00:00

  • Herpesvirus Respiratory Infections in Immunocompromised Patients: Epidemiology, Management, and Outcomes.

    abstract::Among immunocompromised individuals, members of the human Herpesviridae family are frequently encountered pathogens. Cytomegalovirus, herpes simplex virus 1 and 2, varicella zoster virus, Epstein-Barr virus, and human herpesvirus-6, -7, and -8 all establish latency after infection and can reactivate during periods of ...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0036-1584793

    authors: Reid GE,Lynch JP 3rd,Weigt S,Sayah D,Belperio JA,Grim SA,Clark NM

    更新日期:2016-08-01 00:00:00

  • Who Is Safe to Extubate in the Neuroscience Intensive Care Unit?

    abstract::Patients admitted to the neuroscience intensive care unit (NICU) may have respiratory compromise from either central or peripheral neurological pathology, and may hence require intubation and mechanical ventilation for very diverse reasons. Liberation from invasive ventilation, that is, extubation, at the earliest pos...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0037-1608773

    authors: Bösel J

    更新日期:2017-12-01 00:00:00

  • Adult Care in Cystic Fibrosis.

    abstract::Cystic fibrosis (CF) is now more common in adults than children in countries with well-developed health care systems. The number of adults continues to increase and will further increase if the new cystic fibrosis transmembrane conductance regulator (CFTR) modulators are disease modifying. Most of the complex morbidit...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0039-3400289

    authors: Elborn JS

    更新日期:2019-12-01 00:00:00

  • Mycobacterial Lung Disease Complicating HIV Infection.

    abstract::Mycobacterial infections have caused enormous morbidity and mortality in people living with human immunodeficiency virus (HIV) infection. Of these, the most devastating has been tuberculosis (TB), the leading cause of death among HIV-positive persons globally. TB has killed more people living with HIV than any other i...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0036-1572559

    authors: Haas MK,Daley CL

    更新日期:2016-04-01 00:00:00

  • Donor selection and management.

    abstract::This article reviews recent developments in the selection, assessment, and management of the potential lung donor, which aim to increase donor organ use. The scarcity of suitable donor organs continues to limit lung transplantation, but the situation is changing. An expanded donor pool, including the now widespread us...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0033-1348464

    authors: Snell GI,Paraskeva M,Westall GP

    更新日期:2013-06-01 00:00:00

  • Streptococcus pneumoniae: does antimicrobial resistance matter?

    abstract::Over the past 3 decades, antimicrobial resistance among Streptococcus pneumoniae, the most common cause of community-acquired pneumonia (CAP), has escalated dramatically worldwide. In the late 1970s, strains of pneumococci displaying resistance to penicillin were described in South Africa and Spain. By the early 1990s...

    journal_title:Seminars in respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1055/s-0029-1202939

    authors: Lynch JP 3rd,Zhanel GG

    更新日期:2009-04-01 00:00:00