Skip to main content
SpringerLink
Log in

Selective Decontamination of the Digestive Tract

  • Chapter
  • First Online:
Reducing Mortality in Critically Ill Patients

  • 822 Accesses

Abstract

Selective decontamination of the digestive tract (SDD) is an antimicrobial prophylaxis using parenteral (e.g., third-generation cephalosporin) and enteral antimicrobials (e.g., polymyxin E, tobramycin, and amphotericin B) for the control of severe infections in critically ill patients [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Silvestri L, de la Cal MA, van Saene HKF. Selective decontamination of the digestive tract: the mechanism of action is control of gut overgrowth. Intensive Care Med. 2012;38:1738–50.

    Article  Google Scholar 

  2. Liberati A, D’Amico R, Pifferi S, et al. Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev. 2009;2009:CD000022.

    PubMed Central  Google Scholar 

  3. Silvestri L, van Saene HKF, Milanese M, Gregori D, Gullo A. Selective decontamination of the digestive tract reduces bloodstream infections and mortality in critically ill patients: a systematic review of randomised controlled trials. J Hosp Infect. 2007;65:187–203.

    Article  CAS  Google Scholar 

  4. Plantinga NL, de Smet AMGA, Oostdijk EAN, et al. Selective digestive and oropharyngeal decontamination in medical and surgical ICU patients: individual patient data meta-analysis. Clin Microbiol Infect. 2018;24(5):505–13.

    Article  CAS  Google Scholar 

  5. Silvestri L, van Saene HKF, Weir I, Gullo A. Survival benefit of the full selective digestive decontamination regimen. J Crit Care. 2009;24:474e7–474e14.

    Article  Google Scholar 

  6. Price R, MacLennan G, Glen J, on behalf of the SuDDICU collaboration. Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis. BMJ. 2014;348:g2197.

    Article  Google Scholar 

  7. de Jonge E, Schultz MJ, Spanjaard L, et al. Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet. 2003;362:1011–6.

    Article  Google Scholar 

  8. deSmet AM, Kluytmans JA, Cooper BS, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med. 2009;360:20–31.

    Article  CAS  Google Scholar 

  9. Oostdijk EA, Kesecioglu J, Schultz MJ, et al. Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial. JAMA. 2014;312(14):1429–37. Retraction in JAMA 2017;317:1583–1584

    Article  Google Scholar 

  10. Melsen WG, de Smet AMGA, Kluytmans JAJW, et al. Selective decontamination of the oral and digestive tract in surgical versus non-surgical patients in intensive care in a cluster-randomized trial. Br J Surg. 2012;99:232–7.

    Article  CAS  Google Scholar 

  11. Krueger WA, Lenhart F-P, Neeser G, et al. Influence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions, and mortality in critically ill surgical patients. Am J Respir Crit Care Med. 2002;166:1029–37.

    Article  Google Scholar 

  12. Wittekamp BH, Plantinga NL, Cooper BS, et al. Decontamination strategies and bloodstream infections with antibiotic-resistant microorganisms in ventilated patients: a randomized clinical trial. JAMA. 2018;320(20):2087–98.

    Article  Google Scholar 

  13. Abis GSA, Stockman HBAC, Bonjer HJ, et al. Randomised clinical trial of selective decontamination of the digestive tract in elective colorectal cancer surgery (SELECT trial). Br J Surg. 2019;106:355–63.

    Article  CAS  Google Scholar 

  14. Roos D, Dijksman LM, Oudemans-van Straaten HM, et al. Randomized clinical trial of perioperative selective decontamination of the digestive tract versus placebo in elective gastrointestinal surgery. Br J Surg. 2011;98:1365–72.

    Article  CAS  Google Scholar 

  15. Safdar N, Said A, Lucey MR. The role of selective decontamination for reducing infection in patients undergoing liver transplantation: a systematic review and meta-analysis. Liver Transpl. 2004;10:817–27.

    Article  Google Scholar 

  16. van der Voort PHJ, van Saene HKF. The role of SDD in liver transplantation: a meta-analysis. In: van der Voort PHJ, van Saene HKF, editors. Selective digestive tract decontamination in intensive care medicine. Milan: Springer; 2008. p. 165–72.

    Chapter  Google Scholar 

  17. Nathens AB, Marshall JC. Selective decontamination of the digestive tract in surgical patients: a systematic review of the evidence. Arch Surg. 1999;134:170–6.

    Article  CAS  Google Scholar 

  18. D'Amico R, Pifferi S, Leonetti C, et al. Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ. 1998;316:1275–85.

    Article  CAS  Google Scholar 

  19. Landoni G, Rodseth RN, Santini F, et al. Randomized evidence for reduction of perioperative mortality. J Cardiothorac Vasc Anesth. 2012;26:764–72.

    Article  Google Scholar 

  20. Landoni G, Augoustides JG, Guarracino F, et al. Mortality reduction in cardiac anesthesia and intensive care: results of the first international consensus conference. HSR Proc Intensive Care Cardiovasc Anesth. 2011;3:9–19.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Landoni G, Pisano A, Lomivorotov V, et al. Randomized evidence for reduction of perioperative mortality: an updated consensus process. J Cardiothorac Vasc Anesth. 2017;31(2):719–30.

    Article  Google Scholar 

  22. Oostdijk EAN. Selective decontamination: SWAB guidelines revised. Neth J Crit Care. 2019;27:26–7.

    Google Scholar 

  23. van der Voort PHJ, Spronk PE. Insufficient implementation of the SDD concept may yield invalid conclusions. Neth J Crit Care. 2019;27:91.

    Google Scholar 

  24. Silvestri L, van Saene HKF, Bion J. Antipathy against SDD is justified: no. Intensive Care Med. 2018;44:1169–73.

    Article  Google Scholar 

  25. Oostdijk EA, de Smet AM, Kesecioglu J, et al. Decontamination of cephalosporin-resistant Enterobacteriaceae during selective digestive tract decontamination in intensive care units. J Antimicrob Chemother. 2012;67:2250–3.

    Article  CAS  Google Scholar 

  26. Taylor N, Cortes-Puch I, Silvestri L, et al. Antimicrobial resistance. In: van Saene HKF, Silvestri L, de la Cal MA, Gullo A, editors. Infection control in the intensive care unit. 3rd ed. Cham: Springer; 2012. p. 451–68.

    Google Scholar 

  27. Daneman N, Sarwar S, Fowler RA, Cuthbertson BH, on behalf of the SuDDICU Canadian Study Group. Effect of selective decontamination on antimicrobial resistance in intensive care units: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13:328–41.

    Article  Google Scholar 

  28. Mohlmann JE, van Luin M, Mascini EM, et al. Monitoring of tobramycin serum concentrations in selected critically ill patients receiving selective decontamination of the digestive tract: a retrospective evaluation. Eur J Clin Pharmacol. 2019;75:831–6.

    Article  CAS  Google Scholar 

  29. Buelow E, Bello González TDJ, Fuentes S, et al. Comparative gut microbiota and resistome profiling of intensive care patients receiving selective digestive tract decontamination and healthy subjects. Microbiome. 2017;5:88.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

    Luciano Silvestri

  2. Institute of Ageing and Chronic Diseases, University of Liverpool, Liverpool, UK

    Hendrick K. F. van Saene

Authors
  1. Luciano Silvestri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hendrick K. F. van Saene
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy

    Giovanni Landoni

  2. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Martina Baiardo Redaelli

  3. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Chiara Sartini

  4. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy

    Alberto Zangrillo

  5. Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia

    Rinaldo Bellomo

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Silvestri, L., van Saene, H.K.F. (2021). Selective Decontamination of the Digestive Tract. In: Landoni, G., Baiardo Redaelli, M., Sartini, C., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-030-71917-3_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-71917-3_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-71916-6

  • Online ISBN: 978-3-030-71917-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation