Many defend that BTD are more physiological and
cost less than corresponding industrialized enteral diets
(IED)12,13. Yet there is evidence that, in BTD, contamination
may be higher, along with physical and chemical
instability as well as more cumbersome handling
and administration. Microbial colonization may be precipitated
during multiple phases encompassing contaminated
ingredients and equipment, faulty hygiene of
hands and compounding areas, and storage and distribution
routines that favor germ proliferation14. Ideal
calorie and protein density is difficult to achieve, whereas
macro and micronutrient profile rarely fulfills all
requirements of the patients12-16.