Selective decontamination and antibiotic resistance in ICUs

Crit Care. 2015 Jun 24;19(1):259. doi: 10.1186/s13054-015-0967-9.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / prevention & control*
  • Carrier State*
  • Cross Infection / prevention & control
  • Drug Resistance, Bacterial*
  • Humans
  • Intensive Care Units*
  • Intestines / microbiology
  • Pneumonia, Ventilator-Associated / prevention & control*

Substances

  • Anti-Bacterial Agents