The potential for commonly infused drug solutions to support or inhibit microbial growth was explored in this study. Drugs examined were midazolam HCl, morphine sulphate, fentanyl citrate, pethidine HCl, bupivacaine HCl, atracurium besylate, vecuronium bromide, adrenaline, dopamine, dobutamine, noradrenaline, isoprenaline, glyceryl trinitrate, sodium nitroprusside and propofol. All drugs were studied in both diluted and undiluted forms. Of the 15 medications investigated, all except propofol were found to be bactericidal and to reduce fungal growth.

Administration of prophylactic antibiotics is not a proven or universal practice in cerebrospinal fluid (CSF) shunt surgery although case and operative infection rates in hydrocephalic patients average 20 and 8%, respectively. In sequential series from 1969 through 1978 the authors achieved a reduction in case infection rates from 10.9 to 8.9% and in operative infections from 8 to 2.6% with the use of short-term prophylactic methicillin. Comparison of these results to those of other reported series supports the case for short-term prophylactic antibiotics in shunt surgery. Further reduction in shunt sepsis may be possible with the appropriate selection of other semisynthetic penicillins which achieve higher levels in CSF.