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Efficacy of selective digestive decontamination (SDD) for severe acute pancreatitis

Kitamura, N.; Hirano, T.; Moriguchi, T.; Hirasawa, H.; Ohtani, S.

Nihon Rinsho. Japanese Journal of Clinical Medicine 62(11): 2065-2073

2004

ISSN/ISBN: 0047-1852
PMID: 15552890
Document Number: 567740
Bacterial translocation (BT) is involved in the development of pancreatic infection in severe acute pancreatitis (SAP) and influences the prognosis. We should suppress BT to prevent pancreatic infection and improve survival rate. Selective digestive decontamination (SDD) is rational treatment. We should aim at effective SDD, ensuring the following 4 points: (1) enteral antimicrobials, in combination with, (2) parenteral antibiotics given immediately on admission, (3) hand hygiene, (4) surveillance cultures of throat and rectum. Starting enteral feeding as soon as possible and avoiding long-term SDD is useful for maintaining the defenses of the intestinal mucosa and preventing emergence of resistant bacteria. We used glutamine and dietary fiber besides SDD and were able to reduce pancreatic infection.

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