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eCritCare PodcastAuthor: Swapnil Pawar
The landscape of Intensive care is changing. In the era of evidence based medicine, we try to make best possible decision for our patients based on best available evidence. Every fortnight, Dr Swapnil Pawar & Dr Jose Chacko will bring you one hot topic in Critical care. If you want to stay up to date with recent evidence or learn how to critically evaluate the literature in critical care, this podcast is for you. Language: en Genres: Education, Health & Fitness, Medicine Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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#Epi 128 - SuDDICU & The SDD Story with Prof Ian Seppelt
Episode 128
Wednesday, 2 September, 2026
In this episode, Dr Swapnil Pawar sits down with Professor Ian Seppelt, intensivist at Nepean Hospital, Sydney, and one of the lead investigators of the SuDDICU trial, to unpack the decades-long story of Selective Digestive Decontamination (SDD) in intensive care. Ian traces SDD from its haematology origins in the 1970s, through its adoption in the Netherlands, to the extraordinary behind-the-scenes journey of SuDDICU: failed international grants, the pivot from a parallel-group to a crossover cluster design, manufacturing a pharmaceutical-grade SDD preparation from scratch, and navigating ethics approval for a trial without individual patient consent. They discuss: What SDD actually is, and why "selective" matters Why infectious disease physicians resisted a therapy with one of the largest evidence bases in critical care The SuDDICU results: a non-significant mortality benefit, fewer positive blood cultures, fewer resistant organisms, and no signal of emerging resistance The Bayesian view, with a high posterior probability of survival benefit Where SDD goes next: enriched subgroups (neurological injury, pancreatitis), the PREVENT trial of prophylactic ceftriaxone in acute brain injury, and the unanswered question of high-resistance settings Why we adopt some interventions and ignore others: the psychology of evidence in ICU
