Protective effect of rifampicin and clindamycin impregnated devices against <it>Staphylococcus </it>spp. infection after cerebrospinal fluid diversion procedures

<p>Abstract</p> <p>Background</p> <p>Infection is a major complication of cerebrospinal fluid shunting procedures. The present report assesses the efficacy of such catheters in both shunts and external ventricular drains (EVDs) against infection and particularly against <it>Staphylococcus </it>spp. infection.</p> <p>Methods</p> <p>All shunt and EVD procedures performed by means of antibiotic-impregnated catheters (AICs) and non-AICs during the period of study were registered. In cases of shunt procedures, a minimal follow-up of 90 days was considered, as well as de novo insertion and catheter revisions. Single valve revisions were not included. In cases of EVD procedures, those catheters removed before the fifth post-insertion day were not included. A total of 119 cerebrospinal fluid shunting procedures performed with AICs were studied in comparison with 112 procedures performed by means of non-AICs.</p> <p>Results</p> <p>Antibiotic-impregnated catheters were associated with a significant decrease in both overall and staphylococcal infection (<it>p </it>= 0.030 and <it>p </it>= 0.045, respectively). The number needed to treat for AICs was 8 to prevent one infection and 14 to prevent one staphylococcal infection. When comparing with shunts, the use of EVDs was associated with a 37-fold increased likelihood of infection.</p> <p>Conclusions</p> <p>Antibiotic-impregnated catheters are a safe and helpful tool to reduce CSF shunting device-related infections.</p>

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