Miguel A. de la Cal – författare

This book explains the basic concepts of Selective Decontamination of the Digestive tract (SDD) to help those involved in treating critically ill patients to improve outcomes and the quality of care.

SDD has led to major changes in our understanding, the treatment and prevention of infections in critically ill patients over the past 40 years. It is the most studied intervention in intensive care medicine and is the subject of 73 randomized controlled trials, including over 15000 patients and 15 meta-analyses. SDD reduces morbidity and mortality, is cost-effective and safe as SDD does not increase antimicrobial resistance. Correct application of the SDD strategy enables ICU teams to control infections – even in ICUs with endemic antibiotic resistant microorganisms such as methicillin resistant S. aureus (MRSA). 

Describing the concept and application of SDD, and presenting case studies and microbiological flow charts, this practical guide will appeal to intensivists, critical care practitioners, junior doctors, microbiologists and ICU-nurses as well as infection control specialists and pharmacists.  

Infection Control in the Intensive Care Unit has been entirely rewritten in this second edition. All statements are justified by the best available evidence, avoiding unsubstantiated expert opinion. The book contains a new section dedicated to the microbiology of the critically ill; specifically, how to process and interpret surveillance cultures to distinguish the ‘normal’ from the ‘abnormal’ carrier state. There are five totally new chapters dealing with evidence-based infection control molecular techniques for outbreak analysis; clinical virology in neonatal, paediatric and adult intensive care; the six basic principles of the therapy of an infection; and the role of the pharmacist in infection control. Attention is given to special topics such as nutrition, gut mucosal protection, and the control of antimicrobial resistance. The addition of enteral to parenteral antimicrobials contributes to the control of multi-resistant micro-organisms. This completely revised second edition is a must-have for anyone requiring in-depth knowledge in the ever expanding field of infection control.

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.