The role of selective digestive decontamination for reducing infection in patients undergoing liver transplantation: a systematic review and meta-analysis

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Nasia SafdarMichael R Lucey

Abstract

Selective digestive decontamination (SDD) refers to the use of antimicrobials to reduce the burden of aerobic gram-negative bacteria and/or yeast in the intestinal tract to prevent infections caused by these organisms. Liver transplant patients are highly vulnerable to bacterial infection particularly with gram-negative organisms within the first month after transplantation, and SDD has been proposed as a potential measure to prevent these infections. However, the benefit of this procedure remains controversial. We undertook a systematic review and meta-analysis to determine whether SDD is beneficial in reducing infections overall and those caused by gram-negative bacteria in patients following liver transplantation. All studies that evaluated the efficacy of SDD in liver transplant patients were included. Randomized trials that included liver transplant patients given SDD versus either placebo or no treatment or minimal treatment (e.g., oral nystatin alone), and that provided adequate data to calculate a relative risk ratio, were included in the meta-analysis. Our review shows that most studies found SDD to be effective in reducing gram-negative infection. The nonrandomized and uncontrolled trials also showed benefit with SDD ...Continue Reading

References

Jun 1, 1989·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·C V Paya, P E Hermans
Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Apr 1, 1995·Critical Care Medicine·J M Hammond, P D Potgieter
Apr 1, 1995·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J WienerR A Weinstein
Jul 1, 1994·The Journal of Antimicrobial Chemotherapy·G W TetterooH A Bruining
Jan 1, 1994·Transplant International : Official Journal of the European Society for Organ Transplantation·R SteffenP Neuhaus
Mar 1, 1994·Annals of Internal Medicine·M FerrerR Rodriguez-Roisin
Jun 1, 1996·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·P M ArnowM E Irwin
Jul 1, 1997·Computer Methods and Programs in Biomedicine·M CucheratM C Haugh
Dec 31, 1997·American Journal of Surgery·P C KuoL B Johnson
Sep 10, 1998·American Journal of Respiratory and Critical Care Medicine·M Sánchez GarcíaJ A Sacristán del Castillo
Jun 12, 1999·American Journal of Surgery·S L OrloffJ M Rabkin
Jul 18, 2000·The Journal of Hospital Infection·L SilvestriH K van Saene
Dec 21, 2000·Critical Care : the Official Journal of the Critical Care Forum·M H Kollef
Jan 11, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·R PatelR L Thompson
Nov 29, 2002·The International Journal of Artificial Organs·G A Berlakovich
Feb 14, 2003·Mayo Clinic Proceedings·Russell H WiesnerRuud A F Krom
Jun 27, 2003·Intensive Care Medicine·Marc J M BontenRobert A Weinstein

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Citations

Aug 10, 2006·Intensive Care Medicine·Alexandra HeiningerWolfgang A Krueger
Dec 7, 2007·Intensive Care Medicine·R Phillip DellingerJean-Louis Vincent
Jul 29, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Daphne RoosMichael F Gerhards
Mar 7, 2013·Surgical Infections·Dale W BratzlerUNKNOWN Society for Healthcare Epidemiology of America (SHEA)
Dec 26, 2007·Critical Care Medicine·R Phillip DellingerUNKNOWN World Federation of Societies of Intensive and Critical Care Medicine
Apr 22, 2008·Critical Care : the Official Journal of the Critical Care Forum·Sanja JelicPhillip Factor
Sep 25, 2012·Intensive Care Medicine·Luciano SilvestriHendrick K F van Saene
Dec 6, 2006·Intensive Care Medicine·C P StoutenbeekUNKNOWN Working Group on Selective Decontamination of the Digestive Tract
Apr 27, 2012·Expert Opinion on Pharmacotherapy·Luciano SilvestriAndy J Petros
May 15, 2010·Medicina intensiva·F Alvarez LermaO Rodríguez Colomo
Mar 11, 2009·Journal of Critical Care·Hendrick K F van SaenePaul Baines
Mar 31, 2009·Journal of Critical Care·Luciano SilvestriAntonino Gullo
Jun 20, 2007·American Journal of Infection Control·L SilvestriM Perić
Aug 9, 2006·Critical Care Clinics·Antonino GulloGiorgio Berlot
Jul 9, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Nina SinghTimothy Gayowski
Feb 26, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Rafael San-JuanUNKNOWN Spanish Network of Infection in Transplantation/Spanish Network for Research in Infectious Diseases
Mar 8, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G PatelUNKNOWN AST Infectious Diseases Community of Practice
Oct 2, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Els VandecasteeleEric Hoste
May 28, 2014·Transplant Infectious Disease : an Official Journal of the Transplantation Society·E KatchmanS Husain
Sep 13, 2005·International Journal of Antimicrobial Agents·L S StratchounskiJ C Pechere
Apr 10, 2012·Best Practice & Research. Clinical Gastroenterology·Bart van HoekHein W Verspaget
Apr 3, 2013·Microbiological Research·Lei YanJianguo Tang
May 21, 2010·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Luciano SilvestriMarco Milanese
Apr 23, 2014·Current Opinion in Organ Transplantation·Christian van Delden
Jul 9, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hendrik K F van Saene, Durk F Zandstra
Mar 7, 2014·The Cochrane Database of Systematic Reviews·Kurinchi Selvan GurusamyBrian R Davidson
May 30, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shimon Kusne
Dec 5, 2006·Expert Review of Anti-infective Therapy·Kimberly Hanson, Barbara Alexander
Feb 28, 2017·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jasmohan S BajajPatrick M Gillevet
Jul 29, 2016·World Journal of Gastroenterology : WJG·Elena ResinoJose Maria Aguado
Mar 13, 2018·World Journal of Hepatology·Alberto FerrareseMarco Senzolo
Jan 19, 2013·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Dale W BratzlerUNKNOWN Society for Healthcare Epidemiology of America

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