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Meta Analysis
The role of selective digestive tract decontamination on mortality and respiratory tract infections. A meta-analysis.
To review available clinical trials of selective digestive decontamination (SDD) in patients requiring intensive care. ⋯ These results suggest that SDD decreases the overall incidence of acquired pneumonia and tracheobronchitis in patients requiring intensive care. SDD had no apparent effect on the hospital mortality rate. The routine use of SDD cannot be supported by this meta-analysis. SDD may be useful in specific circumstances where a particular ICU or ICU population is found to have an excessive incidence of acquired infections. Any use of SDD should include careful patient surveillance for the emergence of infection due to bacteria not covered by the prophylaxis regimen and due to antibiotic-resistant bacteria.