Background
Selective decontamination of the digestive tract (SDD) was shown to reduce acquisition of resistant bacteria and mortality in ICUs. A significant reduction of bacteremia, candidemia, ventilator-associated pneumonia, respiratory tract and rectal colonization have been found in multicenter, randomized studies. SDD was proven to be clinically safe and cost-effective in multiple clinical studies but has not been accepted by the critical care community as a standard of care. Reluctance to use SDD despite proof to the contrary is mostly explained by its perceived potential to raise bacterial resistance to parenteral and enteral antibiotics or rebound infection after their cessation. We studied the effect of a simplified SDD protocol on Gram-negative colonization of the respiratory tract and bloodstream infection.