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Selective Digestive Decontamination in Intensive Care

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Selective digestive decontamination is a potentially life-saving strategy that is often used for critically ill patients in intensive care. Learn all about selective digestive decontamination, including why and how it is used.

Hospital Caused Infection

Hank is a 43-year-old man who was recently in a severe car accident. The injuries that he sustained in the accident caused him to be in critical condition, and he has been put into the intensive care unit in the hospital.

After two days in intensive care, Hank seemed to be getting better. However, right before he was going to be transferred out of intensive care, Hank developed a staph infection in one of his wounds. This staph infection quickly caused Hank's condition to worsen, and the plans to move him out of intensive care were put on hold. It was later determined that his staph infection was a nosocomial infection, meaning he got the infection due to something in the hospital. (Nosocomial infections are often called 'hospital-acquired infections.')

What could have been done to help prevent Hank from getting this staph infection while in intensive care? One potential answer to this question is selective digestive decontamination.

Selective digestive decontamination can help prevent nosocomial infections, such as this staph infection.
staph infection

Selective Digestive Decontamination (SDD)

Shockingly, about 1 in every 25 hospital patients have at least one nosocomial infection. Patients in intensive care are at increased danger of a nosocomial infection because they are in such a fragile state and any type of infection can cause their health to decline drastically. Two of the most common types of bacteria that cause nosocomial infections are Staphylococcus aureus and Escherichia coli.

Selective digestive decontamination (SDD) is a method to help decrease a patient's risk of getting a nosocomial infection while in intensive care. SDD involves administering antibiotics to a patient, but it also includes other steps and actions as well. These antibiotics help to prevent any bacteria in the hospital from causing infection, and can help prevent infection from bacteria that may have already been in/on the patient, such as in their intestines.

SDD Procedure

There are four main steps in SDD:

  1. Administer IV antibiotics to the patient for about four days.
  2. Give enteral (intestinal) antimicrobials through the mouth or rectum.
  3. Maintain a high level of cleanliness for the patient, making sure both the patient and everything around them remains very clean.
  4. Perform regular cultures of the patient's throat and rectum. This means taking samples from the patient's throat and rectum and testing to see if they contain any potentially infectious microorganisms.

The first step of the SDD process is to administer IV antibiotics for about four days.
IV

Effects of SDD

Research performed to determine the effectiveness of SDD has found that that this procedure:

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