Decontamination of ICU patients

By  |  January 5, 2009 | 

In this controlled cross over trial, 6000 ICU patients were randomized to digestive decontamination (IV cefotaxime for 4 days, and oral tobramycin/colistin/amphotericin), oral decontamination (same oral regimen), or standard care. The (adjusted) absolute risk reduction of 28 day death was 3.5% in the digestive decontamination group, and 2.9% in the oral decontamination group (for NNT of 29 and 34 respectively). There was no difference in antibiotic-resistant pathogens or Cdiff among the study groups. At an estimated cost of $1/day, the authors endorse the oral decontamination regimen to gain significant mortality advantage, with no apparent disadvantages (abstract)

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About the Author: Danielle Scheurer

Danielle Scheurer
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.


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