gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Antibiotic impregnated shunt tubing: just expensive or meaningful?

Antibiotika-imprägnierte Shunt-Schläuche: nur teuer oder doch eine sinnvolle Investition?

Meeting Abstract

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  • corresponding author M. Kiefer - Neurochirurgische Klinik, Universitätsikliniken des Saarlandes, Homburg-Saar
  • R. Eymann - Neurochirurgische Klinik, Universitätsikliniken des Saarlandes, Homburg-Saar

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocFR.04.06

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Kiefer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: According to the recent literature, shunt infections occur with an incidence of about 7% (range: 3 -12%) (metaanalysis of literature of the 1990s). The costs of treating a shunt infection may reach 100.000 €. Objective of this prospective study was to find whether antibiotic impregnated shunt tubing might reduce the incidence of shunt infections.

Methods: A total of 125 consecutive, hydrocephalic patients, - treated for the first time for their chronic hydrocephalus -, were provided with Codman’s Bactiseal® catheters. Prior to shunt insertion each patient had an intraventricular ICP monitoring for at least 48 h. The patients received perioperative intravenous antibiotics on the evening before and 30 minutes before shunt insertion. Different shunt-types, - Miethke PRO-GAV®, adjustable-Codman-Hakim® valve & Miethke Shunt-Assistant® and Miethke GAV®-valve -, were inserted. 92% of the patients received VP-shunts, the remaining VA-shunts. Follow-up examinations took place at 3 and 12 months after operation Average follow-up was 14±5 months (range 3 – 17 months). Average age was 67±16 years.

Results: None of the patients provided with Codman’s Bactiseal catheter had any sign of a shunt infection, neither from a clinical aspect nor from a laboratory investigations at any time after shunt insertion. No intraperitoneal pseudocyst occurred as a sign of a low virulent infection.

Conclusions: Before the use of the Bactiseal catheter, we had a shunt infection rate of 3%., under similar initial conditions of the patients and an identical operative procedure and clinical management. Accordingly, the lack of any shunt infection after 125 patients provided with Bactiseal catheters cannot be disregarded. Assuming our “prior to Bactiseal infection rate”, we would have had to calculate a minimum of 300.000 € to treat shunt infections with these 125 patients. In fact we had additional costs of 40.000 € for 125 Bactiseal catheters. Therefore the use of of Bactiseal seems beneficial from a clinical as well as from an economical viewpoint . However, a prospective, randomized control study is undoubtedly mandatory before a final statement can be made.