Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1784
Title: Asymmetric effects of decontamination using topical antibiotics for the ICU patient.
Author: Hurley, James C.
Issue Date: 2021
Publication Title: Symmetry
Volume: 13
Issue: 6
Start Page: 1027
Abstract: Abstract There are several antiseptic, antibiotic and non-decontamination-based interventions for preventing intensive care unit (ICU) acquired infection. These have been evaluated in >200 studies. Infection prevention using topical antibiotic prophylaxis (TAP) appears to be the most effective. Whether antibiotic use in the ICU may influence the risk of infection among concurrent control patients within the same ICU and result in asymmetrical herd effects cannot be resolved with individual studies examined in isolation. The collective observations within control and intervention groups from numerous ICU infection prevention studies simulates a multi-center natural experiment enabling the herd effects of antibiotics to be evaluated. Among the TAP control groups, the incidences for both ventilator associated pneumonia (VAP) and mortality are unusually high in comparison to literature-derived benchmarks. Paradoxically, amongst the TAP intervention groups, the incidences of mortality are also unusually high and the VAP incidences are similar (i.e., not lower) compared to the incidences among studies of other interventions. By contrast, the mortality incidences among the intervention groups of other studies are similar to those among the intervention groups of TAP studies. Using topical antibiotics to prevent infections acquired within the ICU environment may result in profoundly asymmetrical effects. View Full-Text
URI: http://hdl.handle.net/11054/1784
DOI: https://doi.org/10.3390/sym13061027
Internal ID Number: 01738
Health Subject: BACTEREMIA
TOPICAL ANTIBIOTIC PROPHYLAXIS
STUDY DESIGN
INTENSIVE CARE
MECHANICAL VENTILATION
SELECTIVE DIGESTIVE DECONTAMINATION
HERD EFFECTS
VENTILATOR ASSOCIATED PNEUMONIA
Type: Journal Article
Article
Appears in Collections:Research Output

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