J Antimicrob Chemother
Department of Intensive Care Medicine, Nijmegen University Hospital, The Netherlands.
Published: September 1990
A novel regimen of selective decontamination (SDD) with initial systemic cefotaxime prevented bacterial colonization of the oropharynx and stomach in mechanically ventilated patients. In a three-group study of all patients receiving prolonged mechanical ventilation, patients in control groups A and B received antibiotics only when infection was present. In group A, antibiotics that disturb colonization resistance (CR) were used. In group B, antibiotics use was restricted to antibiotics not affecting CR. Patients in group C received SDD, consisting of norfloxacin, polymyxin E and amphotericin B, administered via a gastric tube and applied to the oropharynx. Group C patients further received an initial five day course of cefotaxime, 500 mg tid. The lower respiratory tract was colonized with microorganisms on admission in about half of the patients, and this persisted in both control groups. In group C, lower respiratory tract colonization was eliminated in all patients after five days. In both control groups about 90% of the patients acquired microbial colonization of the oropharynx and stomach, mostly with Gram-negative bacilli. In group C, only 12% and 24% of the patients acquired colonization of the oropharynx and stomach respectively (P less than 0.001). The oropharynx and stomach were the major sources of microorganisms causing lower respiratory tract infection in both control groups. In group C, elimination of oropharyngeal and gastric colonization completely prevented lower respiratory tract infection from these sources.
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http://dx.doi.org/10.1093/jac/26.suppl_a.59 | DOI Listing |
Front Cell Infect Microbiol
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SAGE Open Med
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College of Medicine King Khalid University, Abha, Saudi Arabia.
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Front Immunol
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Faculty of Life and Biotechnology, Kunming University of Science and Technology, Kunming, China.
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Copenhagen Academy for Medical Education and Simulation, Rigshospitalet, The Capital Region of Denmark, Copenhagen, Denmark.
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PeerJ
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Department of Animal Science, University of Tennessee-Knoxville, Knoxville, TN-Tennessee, United States.
Bovine respiratory disease (BRD) is one of the most common economic and health challenges to the beef cattle industry. Prophylactic use of antimicrobial drugs can alter the microbial communities in the respiratory tract. Considering that the bovine upper respiratory tract microbiome has been associated with generalized health, understanding the microenvironment that influences this microbiome may provide insights into the pathogenesis of BRD.
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