Does Selective Decontamination of the Digestive Tract Reduce In-Hospital Mortality in Critically Ill Adults?

SYNOPSIS: The SuDDICU randomized controlled trial of Australian patients found that selective decontamination of the digestive tract (SDD) did not significantly decrease in-hospital mortality, although the confidence interval around the effect estimate includes a clinically important benefit. In a separate systematic review and meta-analysis that included 32 randomized trials and 24,389 participants, SDD was associated with reduced hospital mortality compared with standard care.

SOURCES: The SuDDICU Investigators for the Australian and New Zealand Intensive Care Society Clinical Trials Group; Myburgh JA, Seppelt IM, Goodman F, et al. Effect of selective decontamination of the digestive tract on hospital mortality in critically ill patients receiving mechanical ventilation: A randomized clinical trial. JAMA 2022;328:1911-1921.

Hammond NE, Myburgh J, Seppelt I, et al. Association between selective decontamination of the digestive tract and in-hospital mortality in intensive care unit patients receiving mechanical ventilation: A systematic review and meta-analysis. JAMA 2022;328:1922-1934.