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Selective digestive decontamination in critically ill children: A survey of Canadian providers

Srinivas Murthy1, Nazima Pathan2, Brian H Cuthbertson3

  • 1University of British Columbia, Canada.

Journal of Critical Care
|March 8, 2017
PubMed

Insights

Selective digestive decontamination (SDD) is not routinely used in Canadian pediatric hospitals due to limited pediatric evidence. Further research on SDD facilitators, barriers, and acceptability is needed before pediatric implementation.

Area of Science:

  • Pediatric critical care medicine
  • Infectious disease prevention
  • Antibiotic stewardship

Background:

  • Selective digestive decontamination (SDD) uses antibiotics to prevent hospital-acquired infections in mechanically ventilated children.
  • Evidence for SDD is strong in adults but limited in pediatric populations.
  • Current use of SDD among North American pediatric physicians is unknown.

Purpose of the Study:

  • To assess the current utilization and perceptions of SDD among pediatric healthcare providers in Canada.
  • To identify barriers and facilitators to SDD implementation in pediatric critical care settings.

Main Methods:

  • An electronic survey was distributed to pediatric critical care and infectious disease specialists in Canada.
  • Survey questions covered current institutional practices, knowledge of SDD evidence, and perceived risks and benefits.
  • Descriptive statistics were used to analyze the survey data.

Main Results:

  • Only 35% of surveyed providers responded, with no Canadian hospitals routinely using SDD.
  • A majority (74%) held neutral opinions on SDD, citing concerns about antibiotic resistance and the intravenous component.
  • Most respondents emphasized the need for pediatric-specific evidence before considering SDD adoption.

Conclusions:

  • There is currently limited knowledge and no routine use of SDD for hospital-acquired infection prevention in Canadian pediatric settings.
  • Pediatric providers require more evidence specific to their patient population before considering SDD.
  • Future research should explore the facilitators, barriers, and acceptability of SDD in pediatric practice.
Abstract

Keywords:
Antibiotic resistanceAntibioticsHospital acquired infections

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