Antibiotic prophylaxis in critically ill patients is clinically effective

Nosocomial infections are important causes of death and illness in critically ill patients. On p 1275 D'Amico et al show in a meta-analysis of over 30 randomised controlled trials including several thousand patients in intensive care units that antibiotic prophylaxis by selective decontamination of the digestive tract reduces respiratory infections. However, death rate is affected only if a systemic antimicrobial drug is added. With the best treatment five and 23 patients would need to be treated to prevent one infection and one death, respectively. Acceptance of the treatment in routine practice, however, can be limited by concern that widespread antibiotic use may lead to resistance. Data are currently inadequate to confirm or rule out this fear.


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Relevant Article

Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials
Roberto D'Amico, Silvia Pifferi, Cinzia Leonetti, Valter Torri, Angelo Tinazzi, and Alessandro Liberati
BMJ 1998 316: 1275-1285. [Abstract] [Full Text] [PDF]

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