Journal Article

Selective Decontamination of the Digestive Tract in Gastrointestinal Surgery: Useful in Infection Prevention? A Systematic Review

Bonjer, Hendrik J., Stockmann, Hein B. A. C., Oosterling, Steven J., Vandenbroucke-Grauls, Christina M. J. E., van Egmond, Marjolein, Abis, Gabor S. A.

2013

Overview

Introduction Gastrointestinal surgery is associated with a high incidence of infectious complications. Selective decontamination of the digestive tract is an antimicrobial prophylaxis regimen that aims to eradicate gastrointestinal carriage of potentially pathogenic microorganisms and represents an adjunct to regular prophylaxis in surgery. Material and Methods Relevant studies were identified using bibliographic searches of MEDLINE, EMBASE, and the Cochrane database (period from 1970 to November 1, 2012). Only studies investigating selective decontamination of the digestive tract in gastrointestinal surgery were included. Results Two randomized clinical trials and one retrospective case–control trial showed significant benefit in terms of infectious complications and anastomotic leakage in colorectal surgery. Two randomized controlled trials in esophageal surgery and two randomized clinical trials in gastric surgery reported lower levels of infectious complications. Conclusion Selective decontamination of the digestive tract reduces infections following esophageal, gastric, and colorectal surgeries and also appears to have beneficial effects on anastomotic leakage in colorectal surgery. We believe these results provide the basis for a large multicenter prospective study to investigate the role of selective decontamination of the digestive tract in colorectal surgery.

• Publisher: Springer US,Springer Nature B.V
• Subject: Administration, Intravenous / Anastomotic Leak - prevention & control / Anti-Bacterial Agents - administration & dosage / Antibiotic Prophylaxis - methods / Antibiotics / Clinical trials / Colorectal surgery / Decontamination - methods / Digestive System Surgical Procedures / Disease prevention / Esophagus / Gastroenterology / Gastrointestinal diseases / Gastrointestinal surgery / Gastrointestinal Tract - microbiology / Humans / Medicine / Medicine & Public Health / Microorganisms / Mortality / Nosocomial infections / Review Article / Sepsis / Surgery / Surgical anastomosis / Surgical Wound Infection - prevention & control / Systematic review