CSF antibiotic prophylaxis for neurosurgical patients with ventriculostomy: a randomised study

Acta Neurochir Suppl. 1998;71:146-8. doi: 10.1007/978-3-7091-6475-4_43.

Abstract

The value of prophylactic antibiotics for patients with ventricular catheter for monitoring and CSF drainage is uncertain. 228 patients were randomised to receive perioperative antibiotics only (Unasyn, Group I) or prolonged antibiotics for the presence of the ventricular catheter (Unasyn and Aztreonam, Group II). The incidence of intracranial and extracranial infection was documented prospectively. Group II patients had a significantly reduced incidence of CSF infection [3/115 (3%) vs 12/113 (11%), p = 0.01] and extracranial infections [23/115 (20%) vs 48/113 (42%), p = 0.002]. CSF pathogens in Group II patients were MRSA and Candida, whereas in Group I, Staphylococci, E coli and Klebsiella. Although prolonged antibiotic prophylaxis significantly reduced the incidence of serious CSF infection as well as extracranial infections, this policy did select resistant or opportunistic pathogens such as Candida and MRSA.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents
  • Antibiotic Prophylaxis*
  • Bacteria / drug effects
  • Catheters, Indwelling*
  • Cerebrospinal Fluid / microbiology
  • Child
  • Child, Preschool
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Humans
  • Infant
  • Male
  • Meningitis, Bacterial / microbiology
  • Meningitis, Bacterial / mortality
  • Meningitis, Bacterial / prevention & control*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Monitoring, Physiologic* / instrumentation
  • Prospective Studies
  • Survival Rate
  • Treatment Outcome
  • Ventriculostomy*

Substances

  • Anti-Bacterial Agents