selective oropharyngeal decontamination (Leiden University Medical Center)

Selective Oropharyngeal Decontamination (SOD) is a prophylactic antimicrobial strategy used in intensive care units (ICUs) to prevent hospital-acquired infections, particularly ventilator-associated pneumonia (VAP) and ICU-acquired bloodstream infections. The strategy involves the topical application of a non-absorbable antimicrobial paste to the oropharynx of critically ill patients, typically those requiring mechanical ventilation. The standard formulation is a combination of two antibiotics, colistin and tobramycin (each at 2% concentration), and the antifungal agent nystatin (1×10^5 units). These agents target potentially pathogenic microorganisms such as *Pseudomonas aeruginosa*, *Staphylococcus aureus*, Enterobacteriaceae, and *Candida* species that colonize the oropharynx. SOD is a subset of the broader Selective Digestive Decontamination (SDD) strategy, which additionally includes enteral and systemic antimicrobial components. It is widely utilized in the Netherlands and has been the subject of extensive observational and clinical studies assessing its impact on patient outcomes and antibiotic resistance.

Other names

selective decontamination of the oropharynx