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Intensive Care Medicine

, Volume 16, Issue 5, pp 307–311 | Cite as

Intestinal decontamination in a polyvalent ICU

A double-blind study
  • J. Godard
  • C. Guillaume
  • M. -E. Reverdy
  • P. Bachmann
  • B. Bui-Xuan
  • A. Nageotte
  • J. Motin
Originals

Abstract

A double blind, placebo-controlled trial was performed to test the efficacy of prevention of nosocomial infections by selective digestive decontamination. Placebo or tobramycin (80 mg) and colistin (100 mg) was given four times daily via the gastric tube. Amphotericin B (500 mg/6h) was administered to all patients. As our ICU is divided into two separate subunits, intestinal decontamination or placebo was administered alternatively to patients of the two subunits during two 3-month periods, separated by a 2-month period without prevention. The decontamination (n=97) and placebo groups (n=84) were similar with respect to age, sex, severity score and diagnostic categories on admission. Intestinal decontamination alone failed to significantly reduce the number of infected patients (26% vs 34.5%,P=0.20), but was effective on ICU-acquired infections (0.33 vs 0.60,p=0.02) especially gram-negative infection rates (0.17 vs 043,p=0.01). The onset of the first ICU-acquired infection was delayed (9 vs 13 days,p<0.001) and incidence of pneumonia (2 vs 13 cases,p<0.01) including bacterial pneumonia (0 vs 8 cases,p<0.01) was significantly decreased. However, mean ICU stay and mortality were not significatly modified by intestinal decontamination.

Key words

Selective digestive tract decontamination Intestinal decontamination Nosocomial infections Prevention of infections 

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Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • J. Godard
    • 1
  • C. Guillaume
    • 1
  • M. -E. Reverdy
    • 2
  • P. Bachmann
    • 1
  • B. Bui-Xuan
    • 1
  • A. Nageotte
    • 3
  • J. Motin
    • 1
  1. 1.Service de RéanimationHôpital Edouard HerriotLyonFrance
  2. 2.Laboratoire de BactéiologieHôpital Edouard HerriotLyonFrance
  3. 3.Service PharmaceutiqueHôpital Edouard HerriotLyonFrance

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