Selective digestive decontamination (SDD) regimens, variously constituted with topical antibiotic prophylaxis (TAP) and protocolized parenteral antibiotic prophylaxis (PPAP), appear highly effective for preventing ICU-acquired infections but only within randomized concurrent control trials (RCCT’s). Confusingly, SDD is also a concept which, if true, implies population benefit. The SDD concept can finally be reified in humans using the broad accumulated evidence base, including studies of TAP and PPAP that used non-concurrent controls (NCC), as a natural experiment. However, this test implicates overall population harm with higher event rates associated with SDD use within the ICU context.

中文翻译：

---

选择性消化去污，是一种看似有效的对个人有益的治疗方案，还是一种对人群有害的有缺陷的概念？

选择性消化道去污 (SDD) 方案，由局部抗生素预防 (TAP) 和方案化的肠胃外抗生素预防 (PPAP) 组成，似乎对预防 ICU 获得性感染非常有效，但仅在随机并行对照试验 (RCCT) 中有效。令人困惑的是，SDD 也是一个概念，如果为真，则意味着人口受益。SDD 概念最终可以使用广泛积累的证据基础在人类中具体化，包括使用非并发控制 (NCC) 的 TAP 和 PPAP 研究，作为自然实验。然而，该测试暗示总体人群伤害与在 ICU 环境中使用 SDD 相关的更高事件发生率。