Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia: a randomized, placebo-controlled, double-blind clinical trial

Article Abstract:

Critically ill patients whose breathing is being assisted mechanically are at risk for ventilator-associated (VA) pneumonia, which carries a high risk of complications and death. VA pneumonia results in a longer stay in the intensive care unit (ICU), greater use of antibiotics, higher costs, and more deaths. Among the complications are bacteria in the blood (bacteremia), infection, and multiple organ failure. Proper sanitary measures in the ICU reduce the incidence of pneumonia, whether it is caused by bacteria present at admission or by bacteria entering the equipment from the nose, mouth or stomach. The digestive tract is the main source of aerobic gram-negative bacteria (AGNB), the most frequent cause of ICU infections. Preventive administration of aerosol antibiotics into the bronchial tubes (airways in the lungs) increased mortality from pneumonia by promoting the development of bacteria resistant to antibiotics. In the current study, 52 patients requiring long-term mechanical ventilation were given either oropharyngeal (mouth and throat) decontamination with nonabsorbable antibiotics, or a placebo (inactive substance). Results showed that oropharyngeal decontamination with antibiotics reduced the incidence of bacterial colonization and pneumonia significantly among these patients (16 percent for antibiotic group versus 78 percent for placebo group). Although 28 percent of patients in the antibiotic group and 26 percent in the placebo group died, the study was too small to draw any conclusions about mortality. In general, mortality among such patients ranges between 30 and 40 percent. Decontamination of the oropharynx appears to cut off the stomach-to-trachea route of infection, without promoting the development of resistant microorganisms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Artificial respiration, Mechanical ventilation, Nosocomial infections, Cross infection

---

The prevalence of nosocomial infection in intensive care units in Europe: results of the European Prevalence of Infection in Intensive Care (EPIC) study

Article Abstract:

Patients in intensive care units (ICU) tend to acquire infections at a high rate. Researchers studied 10,038 intensive care patient case reports for a one-day period. A total of 4,501 (44.8%) of the patients were infected, and 2,064 (20.6%) had acquired the infection in the ICU. The most common infection was pneumonia, which occurred in 47% of the patients, followed by lower respiratory infection, urinary tract infection, and blood infection. Patients at the highest risk of contracting an infection in the ICU were patients who stayed longer than 48 hours, patients on mechanical ventilation, patients diagnosed with trauma, and those with central venous, pulmonary artery, or urinary catheterization. Sixty-two percent of the patients were on antimicrobial drugs, either as a preventive measure or as treatment. The infecting microorganisms included Enterobacteriaceae, Staphylococcus aureus, Pseudomonas aeruginosa, and fungi. Some of these infections can cause death.

Health aspects, Infection, Risk factors, Intensive care units, Critically ill

---

Relationship Between Methodological Trial Quality and the Effects of Selective Digestive Decontamination on Pneumonia and Mortality in Critically Ill Patients

Article Abstract:

Selective digestive decontamination may not reduce the risk of pneumonia in critically ill patients. This procedure involves treating the patient with antibiotics to eliminate potentially harmful bacteria. An evaluation of 32 studies on this topic found that the better the study, the less effective the procedure was in preventing pneumonia.

Usage, Antibiotics

Similar abstracts:

• Abstracts: Antibiotic therapy in preterm premature rupture of membranes: a randomized, prospective, double-blind trial. Trial of labor in patients with a previous lower uterine vertical cesarean section
• Abstracts: Comparison of sublingual captopril and nifedipine in immediate treatment of hypertensive emergencies: A randomized, single-blind clinical trial
• Abstracts: Pediatrics. Effectiveness of Influenza Vaccine in Health Care Professionals : A Randomized Trial
• Abstracts: Diagnosis and cure of the Wolff-Parkinson-White syndrome or paroxysmal supraventricular tachycardias during a single electrophysiological test
• Abstracts: Bone mineral density in premenopausal women receiving long-term physiological doses of levothyroxine. Addisonian crisis as presenting feature in malignancies

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.