Ventilator-associated pneumonia (VAP) remains one of the most common nosocomial infections in the intensive care unit (ICU) affecting one-third of patients that require mechanical ventilation during a noninfectious admission.(1) The estimated incidence varies (depending on definition, screening methods, and patient populations) from 2 to 30 episodes per 1000 days of mechanical ventilation, and the disease develops in 5 to 40% of intubated, critically ill patients.(1-4) whereas mortality shoots up to 20-42% of the VAP patients. the American Thoracic Society and Infectious Diseases Society of America jointly published practical guidelines on hospital-acquired infection, and VAP was defined as a new pneumonia in patients with mechanical ventilation for at least 48 hours and characterized by the presence of a new or progressive infiltrate, signs of systemic infection (temperature, blood cell count), changes in sputum characteristics, and detection of the causative agent(5).

            Several measures have been documented for prevention of ventilator associated pneumonia such as avoiding intubation, minimize duration of intubation, and preventing reintubations, minimal sedation, subglottic suction ⁽⁶⁾ but still it has been a major concern for the health care fraternity. The potential source of ventilator associated pneumonia has been attributed to be the gut and pharyngeal colonization by harmful gram negative organisms, which enter the respiratory tract and the blood stream. SDD targets those organisms from gut with topical antibiotics without getting absorbed from the gut lumen so that they don’t get into blood stream and don’t affect the protective anaerobic flora especially pseudomonas, Enterobacteriaceae group. ⁽⁷⁾

Selective digestive decontamination is another modality of preventing the colonization of gram-negative aerobic bacteria and thereby preventing ventilator associated pneumonia.⁽⁸⁾ Though selective digestive decontamination concept has been incorporated since 1982, ⁽⁹⁾ but till now extensive use  in intensive care setting is rare. Also there has not been any studies done in Indian population as per our knowledge and the literature available. This study aims to study the incidence of ventilator associated pneumonia in patients receiving SDD and to compare that with patients receiving standard of care in an Indian setting.