A before-after study of multi-resistance and cost of selective decontamination of the digestive tract.

摘要: BACKGROUND: We compared standard antibiotic use with an policy based on selective decontamination of the digestive tract (SDD) for cost and microbiology. PATIENTS AND METHODS: A 2-year before-after observational study was performed in 11-bed, mixed medical surgical intensive care unit (ICU). included all consecutive patients admitted to ICU 1 year before after institution SDD (patients within 2-month run-in period were excluded from analysis). In SDD, 513 treated (mean APACHE II 19.5), 529 19.4). RESULTS: The duration mechanical ventilation shorter SDD-treated (median 3, interquartile range [IQR] 2-7 days vs median 4 days, IQR 2-10, p = 0.03). total variable costs, microbiological costs equal both episodes: euro 1,171 versus 1,168 per patient). Aerobic gram-negative bacilli (AGNB) multiresistant AGNB found less frequently patients, RR 0.37 (95% CI 0.33-0.42) 0.28 0.19-0.42). Multi-resistant tracheal secretions urine more than 72 hours admission completely absent patients. CONCLUSION: overall patient during including a supporting care. addition, decreased trend shown towards Length hospital stay. Less frequently, cultures organ sites containing number multi-resistant strains significantly reduced at sites, particular trachea urine. Fewer colonized but these numbers did not reach statistical significance.