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Selective Decontamination of the Digestive Tract and Prevention of Ventilator-Associated Pneumonia
- Harold R. Collard, MD;
- Sanjay Saint, MD, MPH; and
- Michael A. Matthay, MD
- From University of Colorado Health Sciences Center, Denver, CO 80262; Ann Arbor Veterans Affairs Medical Center and the University of Michigan Health System, Ann Arbor, MI 48109; and University of California, San Francisco, San Francisco, CA 94143.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
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•Type with double-spacing
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IN RESPONSE:
Whether the use of SDD leads to ensuing antimicrobial resistance remains a central and unresolved debate in critical care medicine. Baines and van Saene's careful review of newly published articles on this topic adds important information to this debate. Although these data support the argument that SDD does not lead to increased antimicrobial resistance, the published literature still does not provide a definitive answer. We hope that Drs. Baines and van Saene would agree that incorporating the debate over antimicrobial resistance (and the existence of data to support its potential link with SDD) into our recommendations regarding the routine use of SDD was justified. The potential link between SDD and antimicrobial resistance was recently expressed by Dodek and colleagues in their evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia (1): “We make no recommendations regarding selective digestive decontamination using intravenous and topical antibiotics because of insufficient data about antibiotic resistance.” Therefore, in the absence of data that clearly decide this important issue, we stand by our statement that the routine use of SDD should not be recommended.
Harold R. Collard, MD
University of Colorado Health Sciences Center; Denver, CO 80262
Sanjay Saint, MD, MPH
Ann Arbor Veterans Affairs Medical Center and the University of Michigan Health System; Ann Arbor, MI 48109
Michael A. Matthay, MD
University of California, San Francisco; San Francisco, CA 94143
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
