The cyclotron saga continues
William E Powers, Richard L. Maughan · BMJ · 1990
SPEAR is out of place as Ledingham et al them- selves say in the same paper that the respective roles of cefotaxime and of intestinal decontamina- tion "have still to be determined.""My comment on the danger of the systemic component stems from the ability of third generation cephalosporins to stimulate ji lactamases in the bacterial genera that are not uncommon in intensive therapy units.Mv main contention is that further evidence is required of the need for the systemic component, in view of the lack of studies defining its effect, as well as of the respective roles of oropharyngeal and gastrointestinal decontamination and of gastric acidity.P J SANDERSON Edgwarc General Hospital, Egware, MNiddlesex HAS ()AI) I Stotutenbeek CP, van Saenc HKF, Miranda DR, Zandstra DF, ILangrehr 1).'I'he effect of oropharyngeal decontamination using topical non-absorbable antibiotics on the incidence of nosocomial respirators tract infections in multiple trauma patients.T'rauma 1987;27:357-64.2 StouLtenbeek CI', van Saene HKF, Airanda DR, Zandstra DF. 'I'he cffect of-selective contamination of the digestive tract on colonisation and infection rate in multiple trauma patients.