The following is a summary of “Association between selective digestive decontamination and decreased rate of acquired candidemia in mechanically ventilated ICU patients: a multicenter nationwide study,” published in the December 2023 issue of Critical Care by Reizine et al.
In the realm of ICU, where fungal blood infections (ICU-acquired candidemia, ICAC) pose a major threat, the effectiveness of selective digestive decontamination (SDD) against these perilous invaders remains shrouded in uncertainty.
Researchers conducted a retrospective study to explore whether SDD could tame the fungal threat of ICU-acquired candidemia.
They employed the REA-REZO network to incorporate adult patients ventilated for at least 48 hours (January 2017 and January 2023). Performed 1:1 ratio propensity score matching to examine the SDD and ICAC rate link.
The results showed 94,437 patients with at least 48 hours of mechanical ventilation, 3,001 receiving SDD, and 651 developing ICAC. Propensity score matching involved 2,931 patients in the SDD and standard care groups. In both matched cohort analysis and the overall population, ICAC rates were lower in SDD patients (0.8% vs. 0.3%; P=0.012 and 0.7% vs. 0.3%; P=0.006, respectively). Patients with ICAC had a higher mortality rate (48.4% vs. 29.8%; P<0.001). Mortality rates and ICU length of stay in matched populations did not differ with SDD (31.0% vs. 31.1%; P=0.910 and 9 days [5–18] vs. 9 days [5–17]; P=0.513, respectively).
They concluded that while SDD hinted at lower ICAC rates in this limited analysis, its impact failed to extend to improved survival.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-023-04775-1