Critical
Care 2015, 19:259 doi:10.1186/s13054-015-0967-9
Plantinga NL and Bonten MJM
Selective digestive
decontamination (SDD) and selective oropharyngeal decontamination (SOD) have
been associated with reduced mortality and lower ICU-acquired bacteremia and
ventilator-associated pneumonia rates in areas with low levels of antibiotic
resistance. However, the effect of selective decontamination (SDD/SOD) in areas
where multidrug-resistant Gram-negative bacteria are endemic is less clear. It
will be important to determine whether SDD/SOD improves patient outcome in such
settings and how these measures affect the epidemiology of multidrug-resistant
Gram-negative bacteria. Here we review the current evidence on the effects of
SDD/SOD on antibiotic resistance development in individual ICU patients as well
as the effect on ICU ecology, the latter including both ICU-level antibiotic
resistance and antibiotic resistance development during long-term use of
SDD/SOD.
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