Descontaminación digestiva selectiva: protocolo de Getafe

The incidence of ventilator-associated pneumonia (VAP) among mechanically ventilated patients in intensive care units (ICUs) is 10-50%. Notable among preventive measures is selective digestive decontamination (SDD). In 1998, a protocol for SDD was developed and implemented in the ICU of the Hospital Universitario de Getafe. SDD is administered to patients admitted to the ICU who require mechanical ventilation for more than 72 hours and to those with diseases in which the efficacy of SDD has been demonstrated. SDD administration consists of: 1) a short course of systemic antibiotics; 2) oral administration of a solution of non-absorbable antibiotics and topical application in the oropharynx and nose of a non-absorbable antibiotic paste; 3) hygiene and isolation measures. Use of this protocol reduced the rate of VAP by 71% in medical-surgical patients and by 29% in burn patients, without producing a significant increase in multiresistant microorganisms.