S01E18 Selective Digestive Decontamination: What SuDDICU Actually Shows

In this episode of PRISM Rounds, Host and Analyst break down the SuDDICU trial from The New England Journal of Medicine (Oct 29, 2025), testing selective digestive decontamination (SDD) in mechanically ventilated ICU patients using a cluster crossover design across 26 ICUs. We cover the headline result—no statistically significant reduction in 90-day in-hospital mortality—then dig into the key microbiology findings (bloodstream infections and resistant organisms) and the unit-level ecological assessment where noninferiority for resistance outcomes was not confirmed. Practical takeaways focus on what this means for ICU policy, stewardship, and surveillance if SDD is being considered or already in use. Educational use only — not medical advice.PubMed link: https://pubmed.ncbi.nlm.nih.gov/41159880/Tags#CriticalCare #ICU #FOAMed #MedEd #EvidenceBasedMedicine #JournalClub #NEJM #SuDDICU #SelectiveDigestiveDecontamination #SDD #MechanicalVentilation #AntibioticStewardship #AntimicrobialResistance #InfectionPrevention #VentilatorAssociatedPneumonia #Bacteremia #Microbiology #ClinicalTrials #ClusterRandomizedTrial #Noninferiority