ReviewIntensive care medicine2012
Selective decontamination of the digestive tract: the mechanism of action is control of gut overgrowth.
Review in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
What it found
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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
44 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Structural equation modeling the "control of gut overgrowth" in the prevention of ICU-acquired Gram-negative infection.Critical care (London, England) · 2020Pooled it
- Selective decontamination of the digestive tract in gastrointestinal surgery: useful in infection prevention? A systematic review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2013Pooled it
- Microbiota dynamics in a randomized trial of gut decontamination during allogeneic hematopoietic cell transplantation.JCI insight · 2022Trial
- Trial
- Enrichment of the lung microbiome with gut bacteria in sepsis and the acute respiratory distress syndrome.Nature microbiology · 2016Trial
- Gut Hi-C metagenomes of severe COVID-19 patients: bacteria and yeast involved in gut-lung axis.mSphere · 2026Article
- Are arms-based methods required to test the stable unit treatment value assumption (SUTVA) among Cochrane reviews of contagious infection prevention interventions?Global epidemiology · 2026Article
- Targeting Gut-Lung Crosstalk in Acute Respiratory Distress Syndrome: Exploring the Therapeutic Potential of Fecal Microbiota Transplantation.Pathogens (Basel, Switzerland) · 2025Review
- Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study.BMC infectious diseases · 2025Observational
- Estimating the herd effects of antimicrobial prevention interventions on ventilator-associated pneumonia within ICU populations: a cluster randomized trial emulation using data from Cochrane reviews.The Journal of antimicrobial chemotherapy · 2025Article
- A mini-review of the relationship between intestinal microecology and acute respiratory distress syndrome.PeerJ · 2025Review
- Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Visualizing and diagnosing spillover within randomized concurrent controlled trials through the application of diagnostic test assessment methods.BMC medical research methodology · 2024Article
- Review
- Targeted dosing for susceptible heteroresistant subpopulations may improve rational dosage regimen prediction for colistin in broiler chickens.Scientific reports · 2023Article
- Trends in ICU mortality and underlying risk over three decades among mechanically ventilated patients. A group level analysis of cohorts from infection prevention studies.Annals of intensive care · 2023Review
- Establishing the safety of selective digestive decontamination within the ICU population: a bridge too far?Trials · 2023Article
- Altered gut microbiota in the early stage of acute pancreatitis were related to the occurrence of acute respiratory distress syndrome.Frontiers in cellular and infection microbiology · 2023Article
- Candida and the Gram-positive trio: testing the vibe in the ICU patient microbiome using structural equation modelling of literature derived data.Emerging themes in epidemiology · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGut overgrowth is the pathophysiological event in the critically ill requiring intensive care. In relation to the risk of developing a clinically important outcome, gut overgrowth is defined as ≥10(5) potential pathogens including 'abnormal' aerobic Gram-negative bacilli (AGNB), 'normal' bacteria and yeasts, per mL of digestive tract secretion. Surveillance samples of throat and gut are the only samples to detect overgrowth. Gut overgrowth is the crucial event which precedes both primary and secondary endogenous infection, and a risk factor for the development of de novo resistance. Selective decontamination of the digestive tract (SDD) is an antimicrobial prophylaxis designed to control overgrowth.
methodsThere have been 65 randomised controlled trials of SDD in 15,000 patients over 25 years and 11 meta-analyses, which are reviewed. RESULTS AND
conclusionsThese trials demonstrate that the full SDD regimen using parenteral and enteral antimicrobials reduces lower airway infection by 72 %, blood stream infection by 37 %, and mortality by 29 %. Resistance is also controlled. Parenteral cefotaxime which reaches high salivary and biliary concentrations eradicates overgrowth of 'normal' bacteria such as Staphylococcus aureus in the throat. Enteral polyenes control 'normal' Candida species. Enteral polymyxin and tobramycin, eradicate, or prevent gut overgrowth of 'abnormal' AGNB. Enteral vancomycin controls overgrowth of 'abnormal' methicillin-resistant S. aureus. SDD controls overgrowth by achieving high antimicrobial concentrations effective against 'normal' and 'abnormal' potential pathogens rather than by selectivity.
Indexed as
Identifiers
23001446What OpenQuestion holds
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.