Results of trimethoprim-sulfamethoxazole prophylaxis in ventriculostomy and shunting procedures. A double-blind randomized trial

J Neurosurg. 1985 May;62(5):694-7. doi: 10.3171/jns.1985.62.5.0694.


The author reports the results of a study to assess the effectiveness of a trimethoprim-sulfamethoxazole combination as prophylaxis in ventriculostomy or shunting operations. Between 1980 and 1983, 122 patients undergoing shunting procedures were randomly assigned to receive trimethoprim-sulfamethoxazole (Group 1, 62 cases) or a placebo (Group 2, 60 cases). The same regimen was followed at each operation, and the patients were followed for a minimum of 6 months. There was a higher infection rate in the placebo group (14 of 60 patients compared with 4 of 62 patients in the antibiotic group, p less than 0.01). The antibiotic protected against early infections (nine of the 60 patients in Group 2 against none of the patients in Group 1), but not against late infections (four of the 62 in Group 1 compared with five of the 60 in Group 2). During the same period, 52 patients undergoing ventriculostomy only were also randomly assigned to receive trimethoprim-sulfamethoxazole (Group 3) or placebo (Group 4). There were no differences in the infection rates between these groups (one of 25 in Group 3 as against one of 27 in Group 4).

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Bacterial Infections / prevention & control*
  • Cerebral Ventricles / surgery
  • Cerebrospinal Fluid Shunts*
  • Clinical Trials as Topic
  • Double-Blind Method
  • Drug Combinations / therapeutic use
  • Humans
  • Intraoperative Complications / drug therapy
  • Intraoperative Complications / prevention & control
  • Postoperative Complications / prevention & control
  • Premedication*
  • Random Allocation
  • Sulfamethoxazole / therapeutic use*
  • Trimethoprim / therapeutic use*
  • Trimethoprim, Sulfamethoxazole Drug Combination


  • Drug Combinations
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Trimethoprim
  • Sulfamethoxazole