SuDDICU: Selective Decontamination of the Digestive Tract in Intensive Care Unit patients

The primary aim of the SuDDICU—Selective Decontamination of the Digestive tract in Intensive Care Unit patients—study is to test whether using antibiotics to prevent infections increases the number of patients who get better and go home after being critically unwell. We also want to find out whether using antibiotics in this way affects patterns of antibiotic resistance (when antibiotics are no longer effective) in the intensive care unit (ICU).

This is a randomized controlled trial comparing the use of selective decontamination of the digestive tract (SDD) plus standard care to standard care alone on the rate of death in hospital in patients receiving mechanical ventilation in the ICU.

Why is this study being done?

Infections acquired in hospital are a major cause of illness for patients and increase the cost of care. Critically ill patients are particularly at risk of these infections; therefore, there is a need for more evidence to help support better outcomes. Selective decontamination of the digestive tract is a preventive antibiotic strategy that involves the application of antibiotic paste to the mouth and throat, antibiotic liquid into the stomach, and a short course of antibiotics into a vein.

The evidence supporting the use of SDD for saving lives and preventing infections is strong. However, health care professionals in many parts of the world do not use SDD owing to fears of the effects of increased use of antibiotics on the frequency of infections with bugs that have become resistant to the antibiotics. It is clear that health care professionals will not use SDD unless there is more evidence to support that doing so has benefits and does not cause harm by increasing antibiotic resistance rates. This research aims to give health care professionals and patients these data so they can make informed decisions about providing preventive antibiotics as part of care.

International collaboration

The SuDDICU collaboration is an international, investigator-initiated research collaboration that was established in 2009 through networks in Australia, Canada, New Zealand and the U.K.

The study is sponsored in Canada and the U.K. by Sunnybrook Research Institute, and in Australia by The George Institute.

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