Prevention of infectious complications in immunocompromised patients. Part II: Selective decontamination.

The method of selective decontamination of the gastrointestinal tract represents a new possibility of protection of immunocompromised patients against infectious complications with frequent lethal issue. The method is based on employment of such antibiotics and chemotherapeutical drugs that eliminate the aerobic gram-negative microflora and yeasts preserving the anaerobic portion of the bowel microflora that is responsible for the so-called colonization resistance of the intestinal tract. Such a treatment provides patients with more resistance against infection and there is no need for strict reverse isolation. The theoretical exposition of the SD mechanism is given along with instruction on how to use this method and summarizing the hitherto clinical results of its employment. The authors' proper more than 6 year experience is compared with the world literature, and the SD method is stated to be a valuable import in preventing infections in hematological patients. Some unresolved problems and future prospects are also discussed.