Selective Gut Decontamination Reduces Nosocomial Infections and Length of Stay but Not Mortality or Organ Failure in Surgical Intensive Care Unit Patients
| Autor: | Frank B. Cerra, Henry J. Mann, Sharon L. Lehmann, David L. Dunn, Michael A. Maddaus, Nancy N. Konstantinides, Carol L. Wells |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Nystatin medicine.medical_specialty Resuscitation Critical Care Multiple Organ Failure Placebo law.invention Double-Blind Method Randomized controlled trial law Humans Medicine Prospective Studies Candida Antibacterial agent Cross Infection Respiratory Distress Syndrome Bacteria Respiratory distress business.industry Incidence Length of Stay Intensive care unit Surgery Clinical trial Intensive Care Units business Complication Digestive System Norfloxacin |
| Zdroj: | Archives of Surgery. 127:163 |
| ISSN: | 0004-0010 |
| DOI: | 10.1001/archsurg.1992.01420020045007 |
| Popis: | • Suppression of the gut luminal aerobic flora to reduce nosocomial infections was tested in a prospective, randomized, double-blind, placebo-controlled clinical trial in patients in a surgical intensive care unit who had persistent hypermetabolism. Forty-six patients were randomized to receive either norfloxacin, 500-mg suspension every 8 hours, together with nystatin, 1 million units every 6 hours, or matching placebo solutions administered through a nasogastric tube within 48 hours of surgical intensive care unit admission. Selective gut decontamination with the experimental therapy or placebo solutions continued for at least 5 days or until the time of surgical intensive care unit discharge. Patients were monitored with routine surveillance cultures for the development of nosocomial infections, as defined by criteria from the Centers for Disease Control. All other therapy was given as clinically indicated, including systemic antibiotics. The selective gut decontamination group experienced a significant reduction in the incidence of nosocomial infections and a reduced length of stay. However, these results were not associated with a concomitant decrease in progressive multiple organ failure syndrome, adult respiratory distress syndrome, or mortality. ( Arch Surg . 1992;127:163-169) |
| Databáze: | OpenAIRE |
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