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Reduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract
- Source :
- Critical Care Medicine. 19:1242-1246
- Publication Year :
- 1991
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 1991.
-
Abstract
- To compare the effects of two different antibiotic regimes on the colonization and infection rates of critically ill pediatric patients.A prospective randomized trial.A pediatric ICU in a university hospital.Fifty critically ill pediatric patients who required intensive care for at least 4 days were randomly allocated to either the selective parenteral and enteral antisepsis regimen (treatment group, n = 25) or the control group (n = 25).The treatment group received oral nonabsorbable antimicrobial agents (polymyxin E, gentamicin, and amphotericin B) and parenteral cefotaxime, whereas the control group received either perioperative antibiotic prophylaxis or antibiotic therapy according to clinical or microbiological evidence of infection.Both groups were comparable for age, body weight, sex, and severity of illness. Colonization with Gram-negative microorganisms and yeasts in the oropharynx, and digestive and respiratory tracts increased rapidly up to 52% in the control group, whereas there was no colonization with these microorganisms in the treatment group. The occurrence rates of acquired secondary infections in the control and treatment groups were 36% and 8%, respectively (p less than .025). There were no differences between groups in the duration of intensive care or mortality rate.Selective oropharyngeal and gastrointestinal decontamination combined with systemic cefotaxime application allows for a significant reduction of the colonization rate with Gram-negative bacteria and yeasts in critically ill pediatric patients undergoing prolonged intensive care. In addition, it significantly reduces the Gram-negative infection rate of the respiratory system. However, this therapeutic approach does not alter ICU length of stay or mortality rate.
- Subjects :
- Male
Resuscitation
medicine.medical_specialty
Critical Care
Gastrointestinal Diseases
medicine.drug_class
Antibiotics
Intensive Care Units, Pediatric
Critical Care and Intensive Care Medicine
Severity of Illness Index
law.invention
Hospitals, University
Random Allocation
Randomized controlled trial
law
Intensive care
Severity of illness
medicine
Humans
Colonization
Prospective Studies
Prospective cohort study
Intensive care medicine
Cross Infection
business.industry
Infant
Anti-Bacterial Agents
Clinical trial
Austria
Female
business
Subjects
Details
- ISSN :
- 00903493
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....1d3d23f68639ac4fed541a4dc1fa45fd