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Antimicrobial treatment options for neurosurgical ventricular shunt infections in children from 1993 to 2012: a systematic review

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Abstract

Purpose

The aim of this systematic review was to review studies that existed from 1993 to 2012 regarding antimicrobial treatment options of paediatric neurosurgical shunt.

Methods

Studies were identified from MEDLINE, Scopus and Cochrane databases using a search strategy that was registered on the PROSPERO database. Studies were included if they had two or more patients, aged less than 18 years, and also specified the organism and antimicrobial treatment that was used.

Results

The search yielded 2,985 articles, and 76 articles were suitable for full review. In the final qualitative analysis, only eight studies were included, involving 86 participants. The most common antimicrobial regimens for Gram-positive infections was intravenous and intrathecal vancomycin (n = 7), followed by intravenous vancomycin monotherapy.

Conclusion

This systematic review has shown that there are no prospective randomised studies of antimicrobial treatment options for paediatric neurosurgical patients in the last 20 years, and larger prospective studies are urgently required for this serious infection. There is some limited case series showing the benefits of certain antimicrobials such as vancomycin and ceftriaxone, but a larger case series or randomised controlled trial is required, particularly to establish the benefit, if any, of additional intraventricular antimicrobials.

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Acknowledgments

RD would like to thank the staff of Alder Hey Hospital library for their assistance in sourcing some of the publications.

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Authors and Affiliations

  1. Department of Clinical Microbiology, Alder Hey Children’s NHS Foundation Trust, Liverpool, L12 2AP, UK

    Richard J. Drew

  2. Department of Paediatric Infectious Diseases and Immunology, Alder Hey Children’s NHS Foundation Trust, Liverpool, L12 2AP, UK

    Theresa S. Cole, Stéphane Paulus & Andrew Riordan

  3. Department of Neurosurgery, Alder Hey Children’s NHS Foundation Trust, Liverpool, L12 2AP, UK

    Maggie K. Lee & Conor L. Mallucci

Authors
  1. Richard J. Drew
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  2. Theresa S. Cole
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  3. Maggie K. Lee
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  4. Stéphane Paulus
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  5. Conor L. Mallucci
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  6. Andrew Riordan
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Corresponding author

Correspondence to Richard J. Drew.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary digital content Table 1

Title: PRISMA Checklist. Description: This table gives a checklist of the items that should be covered as part of the systematic review. It details the page on which the item is covered in the manuscript (DOC 63 kb)

Supplementary digital content Table 2

Title: List of cases included in the systematic review. Description: This table gives the full details of all the cases included in this systematic review and gives the key parameters that were extracted from the papers (DOCX 40 kb)

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Drew, R.J., Cole, T.S., Lee, M.K. et al. Antimicrobial treatment options for neurosurgical ventricular shunt infections in children from 1993 to 2012: a systematic review. Childs Nerv Syst 30, 841–850 (2014). https://doi.org/10.1007/s00381-013-2333-z

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  • DOI: https://doi.org/10.1007/s00381-013-2333-z

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