Selective Gut Decontamination Reduces Nosocomial Infections and Length of Stay but Not Mortality or Organ Failure in Surgical Intensive Care Unit Patients

Frank B. Cerra, Michael A Maddaus, David L. Dunn, Carol L. Wells, Nancy N. Konstantinides, Sharon L. Lehmann, Henry J. Mann

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)163-169
Number of pages7
JournalArchives of Surgery
Volume127
Issue number2
DOIs
StatePublished - Feb 1992

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Decontamination
Critical Care
Cross Infection
Intensive Care Units
Length of Stay
Placebos
Mortality
Nystatin
Norfloxacin
Investigational Therapies
Multiple Organ Failure
Adult Respiratory Distress Syndrome
Controlled Clinical Trials
Centers for Disease Control and Prevention (U.S.)
Suspensions
Anti-Bacterial Agents
Incidence
Therapeutics

Cite this

Selective Gut Decontamination Reduces Nosocomial Infections and Length of Stay but Not Mortality or Organ Failure in Surgical Intensive Care Unit Patients. / Cerra, Frank B.; Maddaus, Michael A; Dunn, David L.; Wells, Carol L.; Konstantinides, Nancy N.; Lehmann, Sharon L.; Mann, Henry J.

In: Archives of Surgery, Vol. 127, No. 2, 02.1992, p. 163-169.

Research output: Contribution to journalArticle

Cerra, Frank B. ; Maddaus, Michael A ; Dunn, David L. ; Wells, Carol L. ; Konstantinides, Nancy N. ; Lehmann, Sharon L. ; Mann, Henry J. / Selective Gut Decontamination Reduces Nosocomial Infections and Length of Stay but Not Mortality or Organ Failure in Surgical Intensive Care Unit Patients. In: Archives of Surgery. 1992 ; Vol. 127, No. 2. pp. 163-169.
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