Antibiotic-impregnated ventricular shunt catheters(AIVSCs)with 0.15%clindamycin and 0.054%rifampin are commonly used to prevent ventriculo-peritoneal(VP)shunt infections.Initially approved by the United States Food an...Antibiotic-impregnated ventricular shunt catheters(AIVSCs)with 0.15%clindamycin and 0.054%rifampin are commonly used to prevent ventriculo-peritoneal(VP)shunt infections.Initially approved by the United States Food and Drug Administration in 2003(https://www.integralife.com/file/general/1561404015.pdf),they have antimicrobial activity documented for minimum 31 days(https://www.accessdata.fda.gov/cdrh_docs/pdf11/K110560.pdf).These antibiotics were chosen as they cover the majority of Staphylococcus aureus and may provide some activity against coagulase negative staphylococci.1 These normal skin flora account for the majority of VP shunt infections.In the largest randomized controlled trial(RCT)to date,AIVSCs significantly reduced the risk of infection compared with standard shunts(cause-specific hazard ratio(HR)0.38).2 This effect was mainly due to a reduction in staphylococcal infections;the number of gram-negative infections was similar in both groups.Observational studies3–5 and a meta-analysis6 in children support the findings of this RCT.The objective of this study was to examine the spectrum of pathogens,time to infection,and outcomes with AIVSCs vs standard shunts.展开更多
文摘Antibiotic-impregnated ventricular shunt catheters(AIVSCs)with 0.15%clindamycin and 0.054%rifampin are commonly used to prevent ventriculo-peritoneal(VP)shunt infections.Initially approved by the United States Food and Drug Administration in 2003(https://www.integralife.com/file/general/1561404015.pdf),they have antimicrobial activity documented for minimum 31 days(https://www.accessdata.fda.gov/cdrh_docs/pdf11/K110560.pdf).These antibiotics were chosen as they cover the majority of Staphylococcus aureus and may provide some activity against coagulase negative staphylococci.1 These normal skin flora account for the majority of VP shunt infections.In the largest randomized controlled trial(RCT)to date,AIVSCs significantly reduced the risk of infection compared with standard shunts(cause-specific hazard ratio(HR)0.38).2 This effect was mainly due to a reduction in staphylococcal infections;the number of gram-negative infections was similar in both groups.Observational studies3–5 and a meta-analysis6 in children support the findings of this RCT.The objective of this study was to examine the spectrum of pathogens,time to infection,and outcomes with AIVSCs vs standard shunts.
