Authors′ response

• Published in: Indian journal of medical research (New Delhi, India : 1994) India : 1994), 2015-01, Vol.142 (1), p.91-92
• Main Authors: Keyt, H, Faverio, P, Restrepo, M
• Format: Article
• Language: English
• Subjects: Intervention; Mortality; Pneumonia; Staphylococcus infections
• ISSN: 0971-5916

The six studies that showed a significant decrease in mortality were performed in countries or hospitals with a prevalence rate of multi-drug resistant organisms(MDRO) inferior or absent to many hospitals systems around the world, although baseline rates of MDRO are not regularly reported in the studies included in the mortality outcome of the mentioned meta-analysis. [...]the literature has not yet definitively answered the questions: (i) will SDD reduce mortality in places with high or moderate baseline prevalence of MDROs?, and (ii) will SDD protect accurately for the development of MDRO emergence in ICUs with moderate or high baseline prevalent vancomycin-resistant enterococcus (VRE) or methicillin resistant Staphylococcus aureus (MRSA)? [...]a real concern for the medical community in India is how the New Delhi metallo-β-lactamase 1 (NDM-1) in Pseudomonas aeruginosa will behave when exposed to SDD therapy? Clearly, the magnitude of applying an intervention that has been shown to increase the rate of MDROs or that has not been tested in high prevalent MDRO ICUs is a matter of concern. [...]we conclude that the decision to apply an intervention such as SDD to patients in an ICU, goes beyond the baseline reading and understanding of the current results published in the medical literature.