Hendrick K.F. van Saene - Böcker

More than 20 years ago it was recognized by Stoutenbeek and colleagues that patients in the intensive care unit suffered from infections developed whilst being treated. Moreover, the majority of these infections appeared to originate from bacteria that were acquired in the intensive care leading to pathologic colonisation and overgrowth in the gut, subsequently leading to organ site infections. Selective decontamination of the digestive tract (SDD) is an antibiotic strategy which aims to prevent secondary infections in critically ill patients. This book provides both the scientific rationale and the practical approach to nurses, physicians, pharmacists and microbiologists to design a SDD treatment strategy tailored to each individual patient and the local hospital situation.

Intensive care is a rapidly changing area of medicine, and after four years from the 2nd edition the volume editors and authors have deemed necessary to update it. In the recent years, in fact, five new randomised controlled trials and five new meta-analyses demonstrate that selective decontamination of the digestive tract [SDD] is an antimicrobial prophylaxis to prevent severe infections of not only lower airways but also of blood. Additionally, SDD has been shown to reduce inflammation including multiple organ failure and mortality. An intriguing observation is the evidence that SDD using parenteral and enteral antimicrobials reduces rather than increases antimicrobial resistance. Moreover, a new chapter on microcirculation had been added. The volume will be an invaluable tool for all those requiring in depth knowledge in the ever expanding field of infection control.