Selective digestive decontamination in critically ill children: A survey of Canadian providers.

Abstract:

BACKGROUND:Selective digestive decontamination of the digestive tract involves the routine administration of oral, gastric, and intravenous antibiotics to mechanically ventilated children to prevent hospital-acquired infections. It has a strong evidence base in adults, with limited pediatric evidence. Current utilization of this intervention among pediatric physicians in North America is unknown. METHODS:An electronic survey administered to pediatric critical care and pediatric infectious disease providers in Canada. Participants were surveyed on current institutional practices, their current knowledge of the evidence base, and perceptions of the risks and benefits of the intervention. Descriptive statistics were utilized. RESULTS:50 out of 143 (35%) surveyed responded. No hospital in Canada routinely performs SDD and the majority of respondents (74%) have neutral opinions on the subject of SDD. There was concern for increasing antibiotic resistance (43%) and some disagreement with the intravenous component of SDD (46%). The majority of respondents stated a need for pediatric-specific evidence before integrating SDD into their practice, even if further, large adult RCTs were performed. CONCLUSION:Among surveyed providers, there is little knowledge and no use of selective digestive decontamination for the prevention of hospital-acquired infections. Before interventional studies are performed in pediatric practice, there is a need for study of facilitators, barriers and acceptability of SDD in practice.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Murthy S,Pathan N,Cuthbertson BH

doi

10.1016/j.jcrc.2017.02.024

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

169-171

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(17)30192-2

journal_volume

39

pub_type

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