Abstract
Selective digestive decontamination is a prophylactic strategy to reduce the incidence of infection in intensive care unit (ICU) patients by prevention or eradication of the oropharyngeal and gastrointestinal carrier state of potentially pathogenic microorganisms in the gut flora that precedes the development of most ICU-acquired infections. It is one of the most studied interventions in critically ill patients. A lot of research have shown that selective digestive decontamination prevents severe infections, reduces mortality, has no adverse effects, is cost-effective and its use does not show a significant increase in antimicrobial resistance in areas of low antibiotic resistance. However, the impact of this in areas where multi-resistant Gram-negative bacteria are endemic is less clear and of great interest. Some studies also comment on the risk of developing infections after discharge from the ICU. The aim of this article is to provide a narrative review of the main evidence supporting or not supporting the use of selective digestive decontamination in these settings, whether it is safe to use in and after ICU discharge and in different types of patients.