Anaesthesiologie und Reanimation
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Anaesthesiol Reanim · Jan 1989
Randomized Controlled Trial Clinical Trial[A clinical study of selective gut decolonization in 204 long-term ventilated intensive care patients undergoing abdominal and accident surgery].
In a randomized clinical trial the effects of selective digestive decolonization (SDD) on the frequency of pneumonia and sepsis and the rate of lethality as well as the resistance quota and colonization of bacteria were studied in 102 surgical ICU-patients requiring prolonged mechanical ventilation. These patients received non-resorbable antibiotics: 4 x 100 mg of polymyxin B, 4 x 500 mg of amphotericin B, and 4 x 80 mg of tobramycin via gastric tube. One hundred and two patients served as controls. ⋯ A secondary colonization of the oropharynx in patients of the SDD-group could not be observed. 38.8% of the patients in the control group showed potentially pathogenic microorganisms in oropharyngeal swabs. A development of resistance of pseudomonas aeruginosa against tobramycin occurred in 2.3% of the patients in the SDD-group and in 3.1% of the patients in the control group. It can be concluded that the administration of non-resorbable antimicrobials against gram-negative aerobes is an effective method for prevention of potentially fatal pneumonia and sepsis, and for the first time a significant improvement of the survival rate could be demonstrated.