کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3373707 1219306 2007 17 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomized, controlled trials
موضوعات مرتبط
علوم زیستی و بیوفناوری ایمنی شناسی و میکروب شناسی میکروبیولوژی و بیوتکنولوژی کاربردی
پیش نمایش صفحه اول مقاله
Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomized, controlled trials
چکیده انگلیسی

SummaryA systematic review and meta-analysis of randomized controlled trials (RCTs) of selective decontamination of the digestive tract (SDD) was undertaken to evaluate the impact of this procedure on bacterial bloodstream infection and mortality. Data sources were Medline, Embase, Cochrane Register of Controlled Trials, previous meta-analyses, and conference proceedings, without restriction of language or publication status. RCTs were retrieved that compared oropharyngeal and/or intestinal administration of antibiotics as part of the SDD protocol, with or without a parenteral component, with no treatment or placebo in the controls. The three outcome measures were patients with bloodstream infection, causative micro-organisms, and total mortality. Fifty-one RCTs conducted between 1987 and 2005, comprising 8065 critically ill patients were included in the review; 4079 patients received SDD and 3986 were controls. SDD significantly reduced overall bloodstream infections [odds ratio (OR), 0.73; 95% confidence interval (CI), 0.59–0.90; P = 0.0036], Gram-negative bloodstream infections (OR, 0.39; 95% CI, 0.24–0.63; P < 0.001) and overall mortality (OR, 0.80; 95% CI, 0.69–0.94; P = 0.0064), without affecting Gram-positive bloodstream infections (OR, 1.06; 95% CI, 0.77–1.47). The subgroup analysis showed an even larger impact of SDD using parenteral and enteral antimicrobials on overall bloodstream infections, bloodstream infections due to Gram-negative bacteria and overall mortality with ORs of 0.63 (95% CI, 0.46–0.87; P = 0.005), 0.30 (95% CI, 0.16–0.56; P < 0.001), and 0.74 (95% CI, 0.61–0.91; P = 0.0034), respectively. Twenty patients need to be treated with SDD to prevent one Gram-negative bloodstream infection and 22 patients to prevent one death.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Hospital Infection - Volume 65, Issue 3, March 2007, Pages 187–203
نویسندگان
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