In this cluster-randomised, multicentre study, topical plus systemic SDD and SOD reduced the incidence of death, with numbers needed to treat of 29 and 34, after statistical correction for baseline imbalance due to the cluster design of the study.
Level of evidence: 1++ (RCT with very low risk of bias)
References
1.
de la CalMACerdaEGarcia-HierroPSurvival benefit in critically ill burned patients receiving slective decontamination of the digestive tract: a randomised, placebo controlled, double blind trial. Ann Surg2005;241: 424–30.
2.
KruegerWALenhartF-PNeeserGInfluence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions and mortality in critically ill surgical patients: a prospective, stratified, randomised, double blind placebo controlled clinical trial. Am J Respir Crit Care Med2002;166: 1029–37.
3.
RochaLAMartinMJPitaSPrevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract: a randomised, double-blind, placebo controlled study. Intensive Care Med1992;18: 398–404.
4.
de JongeESchultzMJSpanjaardLEffects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet2003;362: 1011–16.
5.
LiberatiAD'AmicoRPifferiTVAntibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database of Systematic Reviews2004; 1: Art.No CD000022.
6.
ChanEYRuestAMeadeMOCookDJ. Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis. BMJ2007;334: 889.