ArticleIntensive care medicine2006
Effects of long-term routine use of selective digestive decontamination on antimicrobial resistance.
Article in Intensive care medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 6 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- The effect of selective decontamination on antimicrobial resistance in intensive care patients: a systematic review and meta-analysis.Scientific reports · 2026Pooled it
- Prevention of ventilator-associated pneumonia, mortality and all intensive care unit acquired infections by topically applied antimicrobial or antiseptic agents: a meta-analysis of randomized controlled trials in intensive care units.Critical care (London, England) · 2011Pooled it
- Guideline
- Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI)).German medical science : GMS e-journal · 2010Guideline
- Guideline
- Single-drug therapy or selective decontamination of the digestive tract as antifungal prophylaxis in critically ill patients: a systematic review.Critical care (London, England) · 2007Pooled it
- Effect of the implementation of a selective digestive decontamination protocol in an intensive care unit.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- Rescuing the Last-Line Polymyxins: Achievements and Challenges.Pharmacological reviews · 2021Review
- The ecological effects of selective decontamination of the digestive tract (SDD) on antimicrobial resistance: a 21-year longitudinal single-centre study.Critical care (London, England) · 2019Observational
- Long-term use of selective digestive decontamination in an ICU highly endemic for bacterial resistance.Critical care (London, England) · 2018Article
- Selective decontamination and antibiotic resistance in ICUs.Critical care (London, England) · 2015Review
- Colistin and tobramycin resistance during long- term use of selective decontamination strategies in the intensive care unit: a post hoc analysis.Critical care (London, England) · 2015Article
- Selective digestive tract decontamination and spread of colistin resistance: antibiotic prophylaxis is not a substitute for hygiene.Antimicrobial agents and chemotherapy · 2014Article
- Selective decontamination in European intensive care patients.Intensive care medicine · 2012Article
- Long-term use of selective decontamination of the digestive tract does not increase antibiotic resistance: a 5-year prospective cohort study.Intensive care medicine · 2011Article
- Probiotics versus antibiotic decontamination of the digestive tract: infection and mortality.Intensive care medicine · 2011Article
- Antibiotics or probiotics as preventive measures against ventilator-associated pneumonia: a literature review.Critical care (London, England) · 2011Review
- Selective decontamination of the digestive tract reduces pneumonia and mortality.Critical care research and practice · 2010Article
- Year in review in Intensive Care Medicine, 2006. II. Infections and sepsis, haemodynamics, elderly, invasive and noninvasive mechanical ventilation, weaning, ARDS.Intensive care medicine · 2007Review
- [Infection-inflammation-sepsis: state of the art and future perspectives. Tübingen Intensive Symposium, 08.10.2005].Der Anaesthesist · 2006Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the distribution of bacterial species and antimicrobial resistance in an ICU during long-term use of selective digestive decontamination (SDD) in the context of national reference data. DESIGN AND
settingFive-year prospective observational study in a 24-bed interdisciplinary surgical ICU of a university hospital (study ICU) participating in the project "Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units" (SARI; reference ICUs). PATIENTS: Resistance data were obtained from all patients; patients intubated for at least 2 days received SDD (colistin, tobramycin, amphotericin B). INTERVENTIONS AND MEASUREMENTS: SDD was performed in 1,913 of 7,270 patients. Antimicrobial resistance was examined in 4,597 (study ICU) and 46,346 (reference ICUs) isolates.
resultsMethicillin-resistant Staphylococcus aureus (MRSA) remained stable (2.76 and 2.58 isolates/1000 patient days) in the study ICU; this was below the German average (4.26 isolates/1000 patient days). Aminoglycoside- and betalactam-resistant Gram-negative rods did not increase during SDD use. Aminoglycoside resistance of Pseudomonas aeruginosa was 50% below the mean value of SARI (0.24 vs. 0.52 isolates/1,000 patient days). The relative frequency of enterococci and coagulase-negative staphylococci (CNS) was higher than in the SARI ICUs (23.2% vs. 17.3%, and 25.0% vs. 20.6%, respectively).
conclusionRoutine 5-year-use of SDD was not associated with increased antimicrobial resistance in our ICU with low baseline resistance rates. Vigorous surveillance and control measures to search and destroy MRSA were considered a mandatory component of the SDD program. The relative increase in enterococci and CNS is of concern requiring further investigation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.