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Use of selective gut decontamination in critically ill children: PICnIC a pilot RCT and mixed-methods study.
Health Technol Assess
February 2024
Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
Background: Healthcare-associated infections are a major cause of morbidity and mortality in critically ill children. In adults, data suggest the use of selective decontamination of the digestive tract may reduce the incidence of healthcare-associated infections. Selective decontamination of the digestive tract has not been evaluated in the paediatric intensive care unit population.
View Article and Find Full Text PDFCeftriaxone to prevent early ventilator-associated pneumonia in patients with acute brain injury: a multicentre, randomised, double-blind, placebo-controlled, assessor-masked superiority trial.
Lancet Respir Med
May 2024
UFR de Médicine et Pharmacie, INSERM U1070, PHAR2, Université de Poitiers, Poitiers, France; Service des Urgences Adultes, Centre Hospitalier Universitaire de Poitiers, Poitiers, France.
Background: Patients with acute brain injury are at high risk of ventilator-associated pneumonia (VAP). The benefit of short-term antibiotic prophylaxis remains debated. We aimed to establish the effect of an early, single dose of the antibiotic ceftriaxone on the incidence of early VAP in patients with severe brain injury who required mechanical ventilation.
View Article and Find Full Text PDFObjective: Selective decontamination of the digestive tract (SDD) is a well-studied but hotly contested medical intervention of enhanced infection control. Here, we aim to characterise the changes to the microbiome and antimicrobial resistance (AMR) gene profiles in critically ill children treated with SDD-enhanced infection control compared with conventional infection control.
Design: We conducted shotgun metagenomic microbiome and resistome analysis on serial oropharyngeal and faecal samples collected from critically ill, mechanically ventilated patients in a pilot multicentre cluster randomised trial of SDD.
Selective decontamination of the digestive tract: concept and application.
Med Intensiva (Engl Ed)
October 2023
Department of Intensive Care Medicine, Hospital Universitario de Getafe, Carretera de Toledo, Getafe, Madrid, Spain. Electronic address:
Selective digestive decontamination (SDD) is a prophylactic strategy aimed at preventing or eradicating bacterial overgrowth in the intestinal flora that precedes the development of most infections in the Intensive Care Unit. SDD prevents serious infections, reduces mortality, is cost-effective, has no adverse effects, and its short- or long-term use is not associated with any significant increase in antimicrobial resistance. SDD is one of the most widely evaluated interventions in critically ill patients, yet its use is not widespread.
View Article and Find Full Text PDFPrevention of ICU-acquired infection with decontamination regimen in immunocompromised patients: a pre/post observational study.
Eur J Clin Microbiol Infect Dis
October 2023
Service de Réanimation, CH de Vannes, 20, Bd Maurice Guillaudot, 56000, Vannes, France.
Purpose: Although the proportion of immunocompromised patients admitted to the ICU is increasing, data regarding specific management, including acquired infection (ICU-AI) prophylaxis, in this setting are lacking. We aim to investigate the effect of multiple-site decontamination regimens (MSD) in immunocompromised patients.
Methods: We conducted a prospective pre-/post-observational study in 2 ICUs in Bretagne, western France.
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