Related Experiment Videos
[Selective bowel decontamination].
Zoltán Szántó1, István Pulay, Lajos Kotsis
1Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelointézet, Altalános, Er- es Mellkassebészeti Osztály, Szolnok. surgic@freemail.hu
Orvosi Hetilap
|May 23, 2006
Summary
Selective Bowel Decontamination (SBD) reduces infections in high-risk intensive care patients by targeting gut microbes. This review surveys SBD literature, finding it beneficial for specific patient groups without increasing MRSA.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Gastroenterology
Context:
- Infective complications significantly contribute to mortality in high-risk intensive care unit (ICU) patients.
- Selective Bowel Decontamination (SBD) is a strategy to prevent endogenous infections by modulating the gut microbiome.
- SBD involves administering antimicrobial and antifungal agents orally to reduce aerobic bacteria and fungi while preserving anaerobes.
Purpose:
- To review the existing literature on Selective Bowel Decontamination since its inception.
- To evaluate the efficacy and application of SBD in various high-risk patient populations.
- To assess the safety profile of SBD, particularly concerning antibiotic resistance.
Summary:
- SBD significantly decreases Gram-negative aerobic bacteria and fungi in the gastrointestinal tract, reducing microbial translocation.
- Positive outcomes have been reported in patients with acute necrotizing pancreatitis, post-liver transplant, polytrauma, severe burns, and hematological malignancies.
- Administration durations vary, with a minimum of one week, and no increase in Methicillin-resistant Staphylococcus aureus (MRSA) has been observed.
Impact:
- SBD demonstrates advantages in selected high-risk surgical patient groups, potentially reducing morbidity and mortality.
- Regular bacteriological sampling is crucial for early detection of emerging antibiotic resistance.
- Further research may refine SBD protocols for optimal patient outcomes in critical care settings.