selective oropharyngeal decontamination (Dutch SDD Trialists Group)

Selective oropharyngeal decontamination (SOD) is a prophylactic antimicrobial regimen used in intensive care units (ICUs) to prevent healthcare-associated infections, specifically ventilator-associated pneumonia (VAP). The regimen 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. SOD aims to eradicate potentially pathogenic microorganisms, such as aerobic gram-negative bacteria and yeasts, from the oropharyngeal cavity, which serves as a reservoir for pathogens that can be microaspirated into the lungs. Unlike selective digestive decontamination (SDD), SOD does not include an intestinal antimicrobial component or a systemic intravenous antibiotic course. SOD has been extensively studied by the Dutch SDD Trialists Group and is considered a standard of care in many Dutch ICUs following evidence from large-scale cluster-randomized trials demonstrating reductions in ICU mortality and infection rates.

Other names

selective oropharyngeal decontamination