Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial.

Importance: Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) are prophylactic antibiotic regimens used in intensive care units (ICUs) and associated with improved patient outcome. Controversy exists regarding the relative effects of both measures on patient outcome and antibiotic resistance.

Objective: To compare the effects of SDD and SOD, applied as unit-wide interventions, on antibiotic resistance and patient outcome.

Selective decontamination of the digestive tract (SDD): is the game worth the candle?

Selective decontamination of the digestive tract (SDD) is an infection prevention strategy in intensive care unit (ICU) patients by topical administration of antibiotics to the mouth and stomach to eradicate potentially pathogenic bacteria and yeast that may cause infections. It also includes a short course of intravenous antibiotics to treat incubating infections at the time of ICU admission. Several randomized, controlled studies, all performed in ICUs with low rates of antibiotic resistance, have shown that SDD prevents ventilator-associated pneumonia and improves survival.

Phosphorus-31 magnetic resonance spectroscopy of skeletal muscle in maternally inherited diabetes and deafness A3243G mitochondrial mutation carriers.

Purpose: To investigate high-energy phosphate metabolism in striated skeletal muscle of patients with Maternally Inherited Diabetes and Deafness (MIDD) syndrome.

Materials And Methods: In 11 patients with the MIDD mutation (six with diabetes mellitus [DM] and five non-DM) and eight healthy subjects, phosphocreatine (PCr) and inorganic phosphate (Pi) in the vastus medialis muscle was measured immediately after exercise using (31)P-magnetic resonance spectroscopy (MRS). The half-time of recovery (t1/2) of monoexponentially fitted (PCr+Pi)/PCr was calculated from spectra obtained every 4 seconds after cessation of exercise.