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Selective digestive decontamination (SDD) with nonabsorbable antibiotics has been shown to reduce infections by gram-negative pathogens and mortality in critically ill patients (JW Infect Dis Jan 7 2009). In a recent retrospective study, researchers investigated whether use of tobramycin and colistin for SDD promotes resistance to these agents.
Tobramycin, colistin, and amphotericin B were included in an SDD protocol introduced in 2002 to control an outbreak of extended-spectrum β-lactamase–producing Klebseilla pneumoniae (ESBL-Kp) infections in an intensive care unit (ICU) in the Netherlands. Using records and stored isolates from ICU patients between January 2001 and January 2008, the researchers retrospectively examined trends in resistan…