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Selective Oropharyngeal Decontamination (SOD) is a clinical infection-prevention regimen primarily utilized in intensive care units (ICUs) to reduce the incidence of ventilator-associated pneumonia (VAP) and ICU-acquired bacteremia. The protocol involves the topical application of a non-absorbable antimicrobial paste to the oropharynx, typically containing a combination of tobramycin, colistin, and an antifungal agent such as amphotericin B or nystatin. By selectively targeting and eliminating pathogenic gram-negative bacteria and fungi colonizing the oropharyngeal cavity, SOD aims to prevent the translocation of these organisms into the lower respiratory tract or bloodstream. Developed and extensively studied by researchers at the University Medical Centre Utrecht, SOD is particularly effective in settings with low levels of antimicrobial resistance.
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