Does Selective Digestive Decontamination Lower Mortality Among Mechanically Ventilated Patients?

In the intensive care unit (ICU), we have interventions designed to lower the incidence of complications such as venous thromboembolism, stress ulcers, central line blood stream infections, and delirium. In a new trial and meta-analysis, researchers examined whether selective decontamination of the digestive tract can help prevent ventilator-associated pneumonia.

Australian investigators cluster randomized nearly 6000 mechanically ventilated patients (by ICU, in alternating 12-month blocks) to either selective decontamination or usual care. Selective decontamination included applying an oral paste of colistin, tobramycin, and nystatin every 6 hours, administering the same combination of antimicrobials enterally every 6 hours, and giving a 4-…