Selective Digestive Tract Decontamination in Intensive Care Medicine: a Practical Guide to Controlling Infection / Edition 1

by Peter H.J. van der Voort, Hendrick K.F. van Saene

Overview

More than 20 years ago it was recognized by Stoutenbeek and colleagues that patients in the intensive care unit suffered from infections developed whilst being treated. Moreover, the majority of these infections appeared to originate from bacteria that were acquired in the intensive care leading to pathologic colonisation and overgrowth in the gut, subsequently leading to organ site infections. Selective decontamination of the digestive tract (SDD) is an antibiotic strategy which aims to prevent secondary infections in critically ill patients. This book provides both the scientific rationale and the practical approach to nurses, physicians, pharmacists and microbiologists to design a SDD treatment strategy tailored to each individual patient and the local hospital situation. Written for:

Product Details

ISBN-13:	9788847006522
Publisher:	Springer Milan
Publication date:	12/10/2007
Edition description:	2008
Pages:	200
Product dimensions:	6.10(w) x 9.25(h) x 0.02(d)

Table of Contents

The history of selective decontamination of the digestive tract.- The concept of SDD.- Infections in critically ill patients: should we change to a decontamination strategy?- Gut microbiology: how to use surveillance samples for the detection of the carrier status of abnormal flora.- Compounding medication for digestive decontamination: pharmaceutical aspects.- Nursing and practical aspects in the application and implementation of SDD.- The effects of hand-washing, restrictive antibiotic use and SDD on morbidity.- The effects of SDD on mortality.- Antimicrobial resistance during 20 years of clinical SDD research.- The costs of SDD.- SDD for the prevention and control of outbreaks.- Preoperative prophylaxis with SDD in surgical patients.- The role of SDD in liver transplantation: a meta-analysis.- Do burn patients benefit from the digestive tract decontamination?- How to design an antibiotic strategy that respects the indigenous flora.- Two clinical cases. Subject index.

Editorial Reviews

Reviewer: David J. Dries, MD (University of Minnesota Medical School)
Description: This monograph describes the controversy and clinical benefits reported for selective digestive tract decontamination (SDD).
Purpose: The rationale for SDD and guides to practical implementation for interested practitioners are provided.
Audience: Senior trainees and critical care practitioners are an appropriate audience for this work which originates from leaders in the practice of SDD in Western Europe.
Features: After a history of the development and controversy surrounding SDD, the book presents a nuts and bolts strategy for implementing such a program. Background information, supporting nursing practices, the microbiology of SDD, and available data reflecting the impact of SDD on outcomes in the ICU are reviewed. Use of SDD in special patient groups including surgical, liver transplantation, and burn patients is also presented. Clinical examples follow the chapter presentations with a brief concluding subject index of three pages. Chapters are clearly written and include tables. References date to within one to two years of publication and include most of the preclinical and clinical work done with SDD to this time.
Assessment: This book reviews a controversial therapy with advocates largely centered in Western Europe. Although I have not used this strategy, my understanding of it was greatly enhanced by these presentations.

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