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Effect of topical and intraventricular antibiotics used during ventriculoperitoneal shunt insertion on the rate of shunt infection—a meta-analysis

  • Review Article - Infection
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Abstract

Introduction

The ventriculoperitoneal shunt is one of the most commonly performed neurosurgical procedures. One of the avoidable complications of shunt surgery is shunt infection. This PRISMA-compliant meta-analysis analysed the effectiveness of topical and/or intraventricular antibiotics in preventing shunt infections in patients undergoing shunt surgery.

Methods

Four databases were searched from inception to 30th June 2021. Only original articles comparing the rate of shunt infection with and without antibiotics were included. Random-effects meta-analysis was used to compare the effect of the use of antibiotics in preventing infection and subgroup analysis for finding differences in various antibiotics.

Results

The rate of shunt infection was 2.24% (53 out of 2362) in the topical antibiotic group in comparison to 5.24% (145 out of 2764) in the control group (p = 0.008). Subgroup analysis revealed that there is no significant difference between the antibiotics used.

Conclusions

Our meta-analysis found that the risk of shunt infection is significantly reduced with the use of topical and intraventricular antibiotics without any serious adverse effect. No side effects of topical or intraventricular antibiotics were reported in the included studies. Further prospective studies are required to establish the safety and optimal dosage of topical antibiotics for them to be used routinely in neurosurgical practice. They can be used in patients at high risk of developing shunt infections till such studies are available.

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Authors and Affiliations

  1. Department of Neurosurgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi, India

    Ganesh VL, Kanwaljeet Garg, Vivek Tandon, Sachin A. Borkar, G. D. Satyarthi, Manmohan Singh, P. S. Chandra & S. S. Kale

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  1. Ganesh VL
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  2. Kanwaljeet Garg
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  3. Vivek Tandon
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  4. Sachin A. Borkar
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  5. G. D. Satyarthi
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  6. Manmohan Singh
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Contributions

Dr Ganesh VL—data collection, writing manuscript, approved final draft. Dr Kanwaljeet Garg—conceptualization, data collection, analysis, writing manuscript, approved final draft. Dr Vivek Tandon—approved final draft, supervision. Dr Sachin A Borkar—approved final draft, supervision. Prof GD Satyarthi—approved final draft, supervision. Prof Manmohan Singh—approved final draft, supervision. Prof P S Chandra—approved final draft, supervision. Prof S S Kale—approved final draft, supervision.

Corresponding author

Correspondence to Kanwaljeet Garg.

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VL, G., Garg, K., Tandon, V. et al. Effect of topical and intraventricular antibiotics used during ventriculoperitoneal shunt insertion on the rate of shunt infection—a meta-analysis. Acta Neurochir 164, 1793–1803 (2022). https://doi.org/10.1007/s00701-022-05248-0

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  • DOI: https://doi.org/10.1007/s00701-022-05248-0

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