gms | German Medical Science

The purpose of this study was to assess the efficacy of antibiotic impregnated ventricular catheter (AIVC) in reducing cerebrospinal fluid (CSF) infection rate after placement of an external ventricular drainage (EVD).

This prospective, randomized study, was conducted over a one-year period (12/1/2003-12/1/2004) and included 46 patients aged 18 or over who underwent placement of an EVD. Each patient was randomly given either ventricular catheter impregnated with antibiotics (clindamycin and rifampicin) (AIVC group) or standard, non impregnated, ventricular catheter (control group). All catheters were inserted in the operating room and were left in place for more than 24 hours. CSF samples were taken for microbiological examination during the procedure and daily until the withdrawal of EVD. bacteriological examination of the ventricular catheter was also performed. Patients with CSF infection prior to procedure were excluded. Infection was defined by the positivity of microbiological examination of either CSF samples or catheter.

48 patients underwent EVD placement during the study period. Two of them were excluded because of evidence of CSF infection prior to procedure. 13 patients received AIVC and 33 received standard catheter. Overall CSF infection rate was 8,7% in our series. The infection rate was 15,4% in the AIVC group and 6% in the control group (NS) There was a trend towards later onset of infection in the AIVC group (10 days vs 4 in the control group).

Our study failed to show any significant reduction of CSF infection rate after EVD placement using antivbiotic -impregnated ventricular catheter. Interpretation of these results should be cautious due to the small number of patients included in our series.