Association between selective digestive decontamination and decreased rate of acquired candidemia in mechanically ventilated intensive care unit (ICU) patients: a multicenter nationwide study
Authors' conclusion
In this study with a low prevalence of ICAC, SDD was associated with a lower rate of ICAC that did not translate to higher survival.
Study context
- Population
- Adults receiving mechanical ventilation for at least 48 h in the ICU, REA-REZO network, January 2017 to January 20233,001 treated with selective digestive decontamination (SDD)
- Participants
- 94,437 adults
- Exposure
- SDD vs standard care
- SDDn = 2,931
- Standard caren = 2,931reference
- Outcome
- Rate of ICU-acquired candidemia (ICAC)
Methodological detailsmulticentre nationwide, non-parsimonious propensity-score matched 1:1
- Multicentre nationwide
- Non-parsimonious propensity-score matched 1:1
Main finding
As reported in the abstract
ICAC rate (matched cohort)
P = 0.012
Observational data: associations, not effects.
Further findings
| Outcome | Standard care | P value |
|---|---|---|
| ICAC rate, overall populationLower rate of ICAC with SDD | 0.7% | P = 0.006 |
Mortality, patients with vs without ICU-acquired candidemia (ICAC)
- Higher mortality in patients with ICAC (48.4% vs 29.8%)
- P < 0.001
Mortality, matched populations
- Did not differ according to SDD (31.0% vs 31.1%)
- P = 0.910
- Matched cohort
ICU LOS, matched populations
- Did not differ according to SDD (9 days [5-18] vs 9 days [5-17])
- P = 0.513
- Matched cohort
Original publication
Association between selective digestive decontamination and decreased rate of acquired candidemia in mechanically ventilated ICU patients: a multicenter nationwide study. Crit Care. Published 16 December 2023. doi:10.
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