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Review
. 2020 Feb;46(2):343-349.
doi: 10.1007/s00134-019-05883-9. Epub 2019 Dec 9.

Selective decontamination of the digestive tract (SDD) in critically ill patients: a narrative review

Bastiaan H J Wittekamp  1 , Evelien A N Oostdijk  2 , Brian H Cuthbertson  3 , Christian Brun-Buisson  4 , Marc J M Bonten  5   6
Affiliations
Review

Selective decontamination of the digestive tract (SDD) in critically ill patients: a narrative review

Bastiaan H J Wittekamp et al. Intensive Care Med. 2020 Feb.

Abstract

Selective decontamination of the digestive tract (SDD) is an infection prevention measure for intensive care unit (ICU) patients that was proposed more than 30 years ago, and that is currently considered standard of care in the Netherlands, but only used sporadically in ICUs in other countries. In this narrative review, we first describe the rationale of the individual components of SDD and then review the evidence base for patient-centered outcomes, where we distinguish ICUs with low prevalence of antibiotic resistance from ICUs with moderate-high prevalence of resistance. In settings with low prevalence of antibiotic resistance, SDD has been associated with improved patient outcome in three cluster-randomized studies. These benefits were not confirmed in a large international cluster-randomized study in settings with moderate-to-high prevalence of antibiotic resistance. There is no evidence that SDD increases antibiotic resistance. We end with future directions for research.

Keywords: Antibiotic resistance; Infection prevention; Selective decontamination.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Components of SDD and SOD. SDD selective digestive tract decontamination, SOD selective oropharyngeal decontamination
See this image and copyright information in PMC

Comment in

References

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