SuDDICU is an international collaboration that was established through research networks in AUS, CAN and the UK in 2009 with the aim of addressing the controversy about the role of SDD in intensive care practice.

Aim: To determine whether SDD is clinically effective and cost-effective at reducing hospital mortality in mechanically ventilated critically ill patients in the ICU without increasing antibiotic resistance, and is cost effective compared to the standard care.

Selective Decontamination of Digestive Tract (SDD) is an infection control strategy designed to reduce mortality by preventing sepsis.

Inclusion criteria:

  1. ​Patient is mechanically ventilated via an endotracheal tube on admission to ICU and is predicted to remain ventilated beyond the end of the calendar day after the day of ICU admission, or
  2. Patient became mechanically ventilated via an endotracheal tube during the ICU stay and is predicted to remain ventilated beyond the end of the calendar day after the day they are first ventilated, or
  3. Patient is receiving mechanical ventilation via an endotracheal tube and is expected to receive ongoing ventilation for a further 48 hours or more despite an earlier prediction that ventilation would be discontinued earlier

Exclusion criteria:

  1. Patient is enrolled in a trial that would interact with the intervention e.g. a trial of a medicinal product with specific antibiotic (not antiseptic) activity
  2. Patient has a known allergy, sensitivity or interaction to trial topical intervention drugs [Note: an allergy to the IV component of the intervention would not lead to trial exclusion but to a change in the IV component]
  3. Patient is known or suspected to be pregnant
  4. Patient is not expected to survive the next 12 hours (patients are eligible despite an active treatment limitation order [any form of limitation of therapy order] if mechanical ventilation is anticipated for 48 hours or more, according to inclusion criteria 1-3 above).