Clinical use of selective decontamination: the concept

Intensive Care Med. 1990:16 Suppl 3:S212-6. doi: 10.1007/BF01709703.

Abstract

Infections can be classified according to: (1) the type of offending microorganism (virus, bacteria, fungi, parasites), (2) according to the clearance by the defence system (T cell dependent/independent) and (3) in case bacteria are the causative agents in Gram-positive and Gram-negative infections. The latter classification in Gram-positive and Gram-negative infections has appeared to have a practical consequence. Gram-negative bacteria, often involved in major infections and yeasts, appear to play practically no role in the intestinal ecological system. Consequently, it is nowadays increasingly attempted to eliminate Gram-negative bacteria and yeasts selectively from the digestive tract with antimicrobial agents. Selective suppression of Gram-positive bacteria may severely affect the ecosystem of the digestive tract. This selective suppression of Gram-negatives must be continued as long as patients are immunocompromised (locally or systemically) and is called selective decontamination of the digestive tract.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / etiology
  • Bacterial Infections / microbiology
  • Digestive System Diseases / drug therapy*
  • Digestive System Diseases / etiology
  • Digestive System Diseases / microbiology
  • Drug Resistance, Microbial
  • Gram-Negative Bacteria*
  • Humans
  • Immunologic Deficiency Syndromes / complications*

Substances

  • Anti-Bacterial Agents