Selective Digestive-Tract Decontamination in Trauma Patients, Revisited

In a randomized, controlled trial involving 401 trauma patients, SDD was associated with significantly fewer infections but not with reduced mortality.

In 1983, Stoutenbeek and colleagues introduced selective decontamination of the digestive tract (SDD) as a way to prevent infection in intensive care medicine. Recent meta-analyses of several small trials in critically ill patients have suggested a substantial reduction in nosocomial pulmonary infections and a modest reduction in overall mortality with use of this technique.

Now, in an industry-supported, multicenter, controlled trial, Stoutenbeek’s research group has investigated SDD’s effects on morbidity and mortality in mechanically ventilated trauma patients with a Hospital Trauma Index-Injury Severity Score ≥16. The 201 patients randomized to SDD received polymyxin E, tobramycin, and amphotericin B four times a day, both enterally and …

Reviewing Author

Thomas Glück, MD