A controlled trial of selective decontamination of the digestive tract in intensive care and its effect on nosocomial infection

Nosocomial infection is a major problem in intensive therapy units (ITUs) and a significant cause of mortality. Selective decontamination of the digestive tract (SDD) has been advocated as a means to reduce ITU morbidity and mortality. Ninety-one patients in a general ITU underwent SDD, consisting of topical polymyxin E, tobramycin and amphotericin B administered throughout the unit stay together with parenteral ceftazidime for the first three days, and were compared with 84 historical and 92 contemporaneous control patients who were treated conventionally. Twenty-seven historical and 32 contemporaneous control patients developed unit-acquired infections, in comparison with only three patients in the SDD group (P