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Comment & Response
April 9, 2019

Decontamination Strategies for Critically Ill Patients

Author Affiliations
  • 1Department of Intensive Care, Gelre Hospitals, Apeldoorn, the Netherlands
  • 2Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
JAMA. 2019;321(14):1409. doi:10.1001/jama.2019.0448

To the Editor A randomized clinical trial investigated the incidence of bloodstream infections with antibiotic-resistant microorganisms in ventilated patients with sequential phases of chlorhexidine 2% mouthwash, selective oral decontamination, and SDD.1 The SDD strategy is aimed at the detection and elimination of the patient’s enteral carrier state of aerobic gram-negative bacteria.2 The authors concluded that the SDD strategy did not prevent bloodstream infections in ICUs with a high prevalence of β-lactamase–resistant Enterobacteriaceae. We would like to raise several questions.