Use of antibiotics with external ventriculostomies

Wyler, Allen R.; Kelly, William A.

doi:10.3171/jns.1972.37.2.0185

Cited by 124 publications

(57 citation statements)

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“…A recent large review of 35 studies published from 1972 to 2013 noted that about half of these studies describe the use of periprocedural antimicrobial therapy [21], but did not assess the efficacy of this practice. Some studies also showed that use of prophylactic antimicrobials resulted in development of ventriculitis due to resistant organisms [162,167]. In one study, patients in the prophylactic antimicrobial arm developed ventriculitis caused by MRSA and Candida spp.…”

Section: Antimicrobial Prophylaxismentioning

confidence: 99%

“…The antimicrobial agent should be given before incision to achieve adequate tissue concentrations and should be continued for as long as 24 hours postoperatively, as studies included in these analyses generally administered therapy for this duration. With respect to CSF drain infection prevention, one review [20] that cited 10 studies addressed the use of prophylactic antimicrobials [47,68,[160][161][162][163][164][165][166][167]. One study with 102 ventriculostomies in 70 patients [165] included 44 patients who received antimicrobials and 26 who did not.…”

Section: Antimicrobial Prophylaxismentioning

confidence: 99%

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2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*

Tunkel

Hasbun

Bhimraj

et al. 2017

Clinical Infectious Diseases

659

671

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The Infectious Diseases Society of America (IDSA) Standards and Practice Guidelines Committee collaborated with partner organizations to convene a panel of 10 experts on healthcare-associated ventriculitis and meningitis. The panel represented pediatric and adult specialists in the field of infectious diseases and represented other organizations whose members care for patients with healthcare-associated ventriculitis and meningitis (American Academy of Neurology, American Association of Neurological Surgeons, and Neurocritical Care Society). The panel reviewed articles based on literature reviews, review articles and book chapters, evaluated the evidence and drafted recommendations. Questions were reviewed and approved by panel members. Subcategories were included for some questions based on specific populations of patients who may develop healthcare-associated ventriculitis and meningitis after the following procedures or situations: cerebrospinal fluid shunts, cerebrospinal fluid drains, implantation of intrathecal infusion pumps, implantation of deep brain stimulation hardware, and general neurosurgery and head trauma. Recommendations were followed by the strength of the recommendation and the quality of the evidence supporting the recommendation. Many recommendations, however, were based on expert opinion because rigorous clinical data are not available. These guidelines represent a practical and useful approach to assist practicing clinicians in the management of these challenging infections.

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Section: Antimicrobial Prophylaxismentioning

confidence: 99%

Section: Antimicrobial Prophylaxismentioning

confidence: 99%

2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*

Tunkel

Hasbun

Bhimraj

et al. 2017

Clinical Infectious Diseases

659

671

View full text Add to dashboard Cite

show abstract

“…8,15,17 All patients in our study received antibiotics at the time of insertion of their ventricular catheters. Yet, a positive CSF culture was found in an alarming 36.5% of patients as compared to 10% in the literature.…”

Section: Discussionmentioning

confidence: 99%

External Ventricular Drainage Infections: Experience From a Tertiary Care Center in Nepal

Pradhanang¹,

Sharma²,

Sedain³

et al. 2016

Nep J Neurosci

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External Ventricular Drainage (EVD) related infection is one of the most dreaded infections in neurosurgical practice. The primary aim of this study was to assess the incidence of EVD infections in our hospital. In addition, we have made an attempt to evaluate the indication for EVD placement, influence of total drainage time in the risk of catheter infection, the most common bacterial spectra in cerebrospinal fluid (CSF) culture, and their antibiotic sensitivity pattern. This is a retrospective study of all patients who underwent EVD placement over a period of two years.Out of 60 patients who underwent EVD placement, 52 met the inclusion criteria for analysis. The ventricular catheters were in place from 1 to 23 days. Overall shunt infection rate was 36.5%. CSF cell count significantly correlated with the occurrence of a positive CSF culture (unpaired t test, p<0.05). The most common bacterial species isolated were Acinetobacter baumannii and Burkholderia cepacia.Despite many advances in care, there is still a significantly high incidence of EVD related infections. Contrary to earlier reports, the most common bacterial grown in our center were quite different and their antibiotic sensitivity varied accordingly.Nepal Journal of Neuroscience 12:67-71, 2015

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“…30 In 1972, Wyler and Kelly presented a retrospective study of 70 patients with and without prophylaxis. 62 Infection rate in the prophylaxis group was 9%, compared with 27% without. Currently, there is no consensus on the use of prophylactic antibiotics.…”

Section: Traumatic Brain Injurymentioning

confidence: 99%

The history of external ventricular drainage

Srinivasan

O’Neill

Jho

et al. 2014

JNS

101

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External ventricular drainage (EVD) is one of the most commonly performed neurosurgical procedures. It was first performed as early as 1744 by Claude-Nicholas Le Cat. Since then, there have been numerous changes in technique, materials used, indications for the procedure, and safety. The history of EVD is best appreciated in 4 eras of progress: development of the technique (1850-1908), technological advancements (1927-1950), expansion of indications , and accuracy, training, and infection control (1995-present). While EVD was first attempted in the 18th century, it was not until 1890 that the first thorough report of EVD technique and outcomes was published by William Williams Keen. He was followed by H. Tillmanns, who described the technique that would be used for many years. Following this, many improvements were made to the EVD apparatus itself, including the addition of manometry by Adson and Lillie in 1927, and continued experimentation in cannulation/drainage materials. Technological advancements allowed a great expansion of indications for EVD, sparked by Nils Lundberg, who published a thorough analysis of the use of intracranial pressure (ICP) monitoring in patients with brain tumors in 1960. This led to the application of EVD and ICP monitoring in subarachnoid hemorrhage, Reye syndrome, and traumatic brain injury. Recent research in EVD has focused on improving the overall safety of the procedure, which has included the development of guidance-based systems, virtual reality simulators for trainees, and antibiotic-impregnated catheters.

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Use of antibiotics with external ventriculostomies

Cited by 124 publications

References 0 publications

2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*

2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*

External Ventricular Drainage Infections: Experience From a Tertiary Care Center in Nepal

The history of external ventricular drainage

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