Neurosurgical Review

, Volume 12, Issue 3, pp 239–244 | Cite as

Antibiotic single-dose prophylaxis of shunt infections

  • Jochen Blum
  • Manfred Schwarz
  • Dieter Voth
Section on child neurosurgery
Received:
Accepted:

Abstract

Shunt infections after implantation or revision of a shunt for CSF drainage in hydrocephalic patients are serious complications. In view of their frequency, this study investigated the efficacy of prophylactic administration of a single dose of the antibiotic cefazedone in reducting in the post-operative infection rate.

Fifty children of up to 14 years of age suffering from hydrocephalus of various etiologies were treated prophylactically and compared with a similar untreated group.

The diagnosis of infection was based mainly on microbiological and clinical observations and investigations. Classical infection parameters were also recorded and evaluated, but played only a secondary role in establishing the diagnosis as they can change post-operatively without an infection being present.

The infection rates observed were 6% in the group of patients who received antibiotic treatment prophylactically and 14% in the untreated control group.

Keywords

Cefazedone cerebrospinal fluid shunt hydrocephalus prophylactic antibiotics shunt infection silicone elastomer 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. [1]
    Ajir F, AB Levin, TA Duff: Effect of prophylactic methicillin on cerebrospinal fluid shunt infections in children. Neurosurgery 9 (1981) 6–8Google Scholar
  2. [2]
    Alvarez-Garijo JA, MV Mengual: Infection rate with and without prophylactic antibiotic therapy after shunt insertion for hydrocephalus. Monogr Neural Sci 8 (1982) 66–68Google Scholar
  3. [3]
    Blomstedt GC: Results of trimethoprim-sulfamethoxazole prophylaxis in ventriculostomy and shunting procedures. A double-blind randomized study. J Neurosurg 62 (1985) 694–697Google Scholar
  4. [4]
    Chapman PH, LF Borges: Shunt infections. Prevention and treatment. Clin Neurosurg 32 (1985) 652–664Google Scholar
  5. [5]
    Daschner F: Perioperative Antibiotikaprophylaxe. Eine Dosis, ein Tag oder mehrere Tage? Klinikarzt 12 (1983) 255–256Google Scholar
  6. [6]
    DiPiro JT, RP Cheung, TA Bowden, JA Mansberger: Single dose systemic antibiotic prophylaxis in surgical wound infections. Am J Surg 152 (1986) 552–559Google Scholar
  7. [7]
    Djindjian M, MJ Fevrier, G Otterbein, JC Soussy: Oxacillin prophylaxis in cerebrospinal fluid shunt procedures: results of a randomized open study in 60 hydrocephalic patients. Surg Neurol 25 (1986) 178–180Google Scholar
  8. [8]
    Fitzgerald D: Use of prophylactic antibiotics in otologic and neuro-otologic surgery. Am J Otology 6 (1985) 121–125Google Scholar
  9. [9]
    Haines SJ, F Taylor: Prophylactic methicillin for shunt operations. Effect on incidence of shunt malfunction and infection. Child's brain 9 (1982) 10–22Google Scholar
  10. [10]
    Haines SJ: Antibiotic prophylaxis in neurosurgery. Clin Neurosurg 33 (1986) 633–642Google Scholar
  11. [11]
    Lambert M, AE MacKinnin, A Vaishnav: Comparison of two methods of prophylaxis against CSF shunt infection. Z Kinderchir 39 (1984) 109–110Google Scholar
  12. [12]
    McCullough DC, JG Kane, JH Presper, H Wells: Antibiotic prophylaxis in ventricular shunt surgery. I. Reduction of operative infection rates with methicillin. Child's brain 7 (1980) 182–189Google Scholar
  13. [13]
    Peters G: Untersuchungen zur Pathogenese der Staphylokokkeninfektion von Kunststoffimplantaten und intravasalen Kathetern. Infection 12 (1984) 235–239Google Scholar
  14. [14]
    Peters G, G Pulverer: Staphylokokken-bedingte Infektionen von implantierten Kunststoffmaterialien. FAC 3–4 (1984) 469–475Google Scholar
  15. [15]
    Rieder MJ, TC Frewen, RF DelMaestro, A Coyle, S Lovell: The effect of cephalothin prophylaxis on postoperative ventriculoperitoneal shunt infections. CMAY 136 (1987) 935–938Google Scholar
  16. [16]
    Savitz MH, SS Katz: Rationale for prophylactic antibiotics in neurosurgery. Neurosurgery 9 (1981) 142–144Google Scholar
  17. [17]
    Savitz MH, SS Katz: Prevention of primary wound infection in neurosurgical patients: a 10-year study. Neurosurgery 18 (1986) 685–688Google Scholar
  18. [18]
    Schmidt K, F Gjerris, O Osgaard, EF Hvidberg, JE Kristiansen, B Dahlerup, C Kruse-Larsen: Antibiotic prophylaxis in cerebrospinal fluid shunting: a prospective randomized trial in 152 hydrocephalus patients. Neurosurgery 17 (1985) 1–5Google Scholar
  19. [19]
    Serlo W, E Heikkinen, L von Wendt, I Pietarinen, K Kouvalainen: Infection prophylaxis in hydrozephalus shunt surgery, an evaluation of different regimes. Z Kinderchir Kongreßbericht (1984) 121–127Google Scholar
  20. [20]
    Shapiro M, U Wald, E Simchen, S Pomeranz: Randomized clinical trial of intraoperative antimicrobial prophylaxis of infection after neurosurgical procedures. J Hosp Infect 8 (1986) 283–295Google Scholar
  21. [21]
    Voth D: Perioperative prevention of infection in neurosurgery. In:Schönfeld H, FE Hahn (eds): Antibiotics and chemotherapy. S. Karger-Verlag, Basel 1985Google Scholar
  22. [22]
    Walters BC, HJ Hoffman, EB Hendrick, RP Humphreys: Decreased risk of infection in cerebrospinal fluid shunt surgery using prophylactic antibiotics — a case-controll study. Z Kinderchir 40 Supp I (1985) 15–18Google Scholar
  23. [23]
    Yogev R: Cerebrospinal fluid shunt infections: a personal view. Pediatr Infect Dis 4 (1985) 113–118Google Scholar
  24. [24]
    Young RF: Perioperative antibiotics prophylaxis for prevention of postoperative neurosurgical infections. J Neurosurg 66 (1987) 701–705Google Scholar
  25. [25]
    Younger JJ, JC Simmons, FF Barrett: Failure of single-dose intraventricular vancomycin for cerebrospinal fluid shunt surgery prophylaxis. Pediatr Infect Dis J 6 (1987) 212–213Google Scholar

Copyright information

© Walter de Gruyter & Co 1989

Authors and Affiliations

  • Jochen Blum
    • 1
    • 2
  • Manfred Schwarz
    • 1
  • Dieter Voth
    • 1
  1. 1.Department of NeurosurgeryMainz University HospitalMainzWest Germany
  2. 2.Neurochirurgische Klinik und PoliklinikUniversitätskliniken MainzMainzWest Germany

Personalised recommendations