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Selective digestive decontamination protocol may reduce K. pneumonia infections
BOSTON — A selective digestive decontamination protocol may have reduced the prevalence of carbapenem-resistant Klebsiella pneumoniae infections, according to results presented at the 50th Interscience Conference on Antimicrobial Agents and Chemotherapy.
Forty adults with a positive rectal swab culture for carbapenem-resistant infection were enrolled in the analysis. The study was conducted in Israel.
Participants were randomly assigned over a 20-month period to receive selective digestive decontamination via oral gentamicin and polymyxin E gel 0.5 g four times a day; oral solutions of gentamicin 80 mg four times a day; and polymyxin E 1 x 106 units four times a day for 7 days. Patients in the placebo arm received an oral placebo gel and two placebo oral solutions four times a day for 7 days.
Clinicians observed strict contact precautions. Baseline screening results indicated that more than 30% of participants had carbapenem-resistant K. pneumoniae bacteriuria, and ≥60% had a positive groin culture.
All throat cultures became negative in the selective digestive decontamination arm, according to the results. At the two-week point, significantly fewer rectal cultures were positive in the treatment arm vs. the placebo arm (P<.05). The researchers did not observe a change in groin cultures.
The researchers suggested that in uncontrolled outbreaks and selected clinical cases of carbapenem-resistant K. pneumoniae, selective digestive decontamination should be considered as an additional measure to restrain dissemination and infections.
For more information:
- Saidel-Odes L. K-250a. Presented at: 50th Interscience Conference on Antimicrobial Agents and Chemotherapy. Boston, Sept. 12-15, 2010.