A review of the medical literature for evidence of whether the use of intravenous antibiotics, or devices impregnated with antibiotics, reduce the risks of infection during the surgical placement of catheters for the drainage of excess fluid from the brai

An intracranial ventricular shunt is a device (catheter/tube) used to drain an excess of cerebrospinal fluid from the brain. (Cerebrospinal fluid is a clear body fluid released into the subarachnoid space; the subarachnoid space surrounds the brain and the spinal cord.) Patients with intracranial ventricular shunts are prone to infection. Some doctors give either antibiotic drugs or use antibiotic-impregnated devices to reduce the risk of infection. Our review included randomized controlled trials that compared the incidence of shunt infection in patients who were given preventive antibiotic therapy with those who did not receive these drugs. We also included trials comparing antibiotic-impregnated shunt systems with those who received non-antibiotic impregnated shunts. We included seventeen trials in our review. Although the available data does not provide much detail on mortality or the adverse events caused by antibiotics (an adverse event is an incident in which harm resulted to a person receiving the health care) it does support the use of preventative systemic prophylactic antibiotics for the first 24 hours postoperatively following an intracranial ventricular shunt operation or the use of antibiotic-impregnated catheters. However this data was obtained from an intermediary outcome which is the rate of shunt infections. Therefore although the evidence suggests that the use of antibiotics is beneficial in reducing the incidence of shunt infection more research is needed to confirm their benefit.