Selective digestive decontamination (SDD) reduces the rate of infection and improves the outcomes of patients admitted to an intensive care unit (ICU). A risk associated with its use is the development of multi-drug-resistant organisms. We hypothesized that a 1-day reduction in systemic antimicrobial exposure in the SDD regimen would not affect the outcomes of our patients. In this before-and-after study design, 199 patients and 248 patients were included in a 3-day SDD group and a 2-day SDD group, respectively. The rates of hospital-acquired pneumonia and ICU infections were similar in both groups. The rates of bloodstream infection and bacteriuria were significantly lower in the 2-day SDD group than in the 3-day SDD group. Compared with the patients in the 3-day group, the patients in the 2-day SDD group received fewer antibiotics and less exposure to mechanical ventilation, and they used fewer ICU resources. The rates of ICU mortality and 28-day mortality were similar in both groups. The incidence of multi-drug-resistant organisms was similar in both groups. Within the limitations inherent to our study design, reducing the exposure of prophylactic systemic antibiotics in the SDD setting from 3 days to 2 days was not associated with impaired outcomes. Future randomized controlled trials should be conducted to test this hypothesis and investigate the effects on the development of multi-drug resistant organisms.

选择性消化净化（SDD）可以降低感染率，并改善重症监护病房（ICU）住院患者的结局。与使用它有关的风险是产生多药耐药性生物。我们假设，SDD方案中全身性抗菌素暴露减少1天不会影响我们患者的结局。在此前后研究设计中，SDD 3天组和SDD 2天组分别包括199名患者和248名患者。两组的医院获得性肺炎和ICU感染率相似。2天SDD组的血流感染率和菌尿率显着低于3天SDD组。与三天组的患者相比，在2天的SDD组中，患者接受的抗生素较少，机械通气的暴露较少，并且使用的ICU资源也较少。两组的ICU死亡率和28天死亡率相似。两组中多重耐药菌的发生率相似。在我们的研究设计固有的局限性内，将SDD中预防性全身性抗生素的暴露时间从3天减少到2天与结果受损无关。未来应进行随机对照试验以检验这一假设，并研究其对耐多药生物体发展的影响。两组中多重耐药菌的发生率相似。在我们的研究设计固有的局限性内，将SDD中预防性全身性抗生素的暴露时间从3天减少到2天与结果受损无关。未来应进行随机对照试验以检验这一假设，并研究其对耐多药生物体发展的影响。两组中多重耐药菌的发生率相似。在我们的研究设计固有的局限性内，将SDD中预防性全身性抗生素的暴露时间从3天减少到2天与结果受损无关。未来应进行随机对照试验以检验这一假设，并研究其对耐多药生物体发展的影响。