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

Selective decontamination and antibiotic resistance in ICUs.

Author information

1
University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands. N.L.Plantinga@umcutrecht.nl.
2
University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands.

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.

PMID:
26104045
PMCID:
PMC4479224
DOI:
10.1186/s13054-015-0967-9
[Indexed for MEDLINE]
Free PMC Article

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