Selective gastrointestinal decontamination (SDD) was proposed over 30 years ago as an infection prevention measure for intensive care unit (ICU) patients and is now considered standard care in the Netherlands, although it is used in other countries. It has only been used sporadically in the ICU. In this narrative review, we first describe the rationale for each component of his SDD, then review the evidence base for patient-centered outcomes, highlighting ICUs with low prevalence of antibiotic resistance versus those with moderately high resistance. Distinguish ICUs with a prevalence of in settings with low prevalence of antibiotic resistance, SDD has been associated with improved patient outcomes in his three cluster randomized studies. Selective digestive decontamination (SDD) and selective oropharyngeal decontamination (SOD) are effective in improving survival in ICU patients. This study examined possible effects in surgical and non-surgical patients. Nosocomial infections are common in critically ill patients, causing complications and even death in the intensive care unit (ICU). Selective gastrointestinal decontamination (SDD) aims to prevent infections in the ICU. SDD consists of a paste of a non-absorbable antibiotic (such as polymyxin E, tobramycin, or amphotericin B) applied to the mouth, a suspension of the same antibiotic administered to the gastrointestinal tract, and a short course of systemic antibiotics. As an alternative, selective oropharyngeal decontamination (SOD) is being considered, especially to prevent ventilator-associated pneumonia. In this case, the same topical antibiotic is applied only to the oropharynx. Several studies have evaluated the effects of SDD and SOD, and many have demonstrated positive effects on infection rates. Improved survival has been documented for SDD in three studies and for SOD in one study. In a recent study, both SDD and SOD were associated with a significant relative reduction in 28-day mortality of 13 and 11 percent, respectively, compared with standard care in a mixed population of 5939 of her ICU patients. The question remains whether the efficacy of selective decontamination differs in specific subgroups of patients. The meta-analysis results suggest that a surgical ICU patient may benefit more from her SDD than a medical ICU patient. It is also unknown whether surgical and non-surgical patients benefit differently from SDD or SOD. A current post hoc analysis of a recent multicenter study was performed to determine the impact of her SDD and SOD in surgical and non-operative ICU patients. The bacterial ecology of the oropharynx of patients in the intensive care unit has undergone profound changes. To reduce the incidence of these complications, approaches to decontamination include the use of various forms of antibiotic prophylaxis or topical oropharyngeal antiseptics (most often chlorhexidine). Antibiotic prophylaxis includes any combination of oropharyngeal, intragastric, and intravenous antibiotics. However, here are her two main approaches. Selective gastrointestinal decontamination consists of oropharyngeal and gastric application of non-absorbable antibiotics, such as polymyxin, tobramycin, and amphotericin, followed by brief administration of intravenous antibiotics, such as cefotaxime. Oropharyngeal antibiotics are usually applied as a paste four times a day during routine oral care. Gastric antibiotics are administered as a suspension through a nasogastric tube. Twice-weekly bacteriological monitoring can often be used to assess the effectiveness of decontamination. The choice of therapeutic antibiotics aims to minimize interference with the native anaerobic flora by avoiding agents such as broad-spectrum penicillins. Selective oropharyngeal decontamination is the application of topical antibiotic paste to the oropharynx only, without the use of enteral or empirical intravenous antibiotics. Chlorhexidine is applied in gel or liquid form up to four times daily as part of regular oral care.