Antibiotic Reservoir Injection Reduces Shunt Infection in Adults

BACKGROUND: Shunt infections are a major complication following ventricular shunts in adults that lead to increased heath care costs, patient morbidity, and mortality. Methods to decrease shunt infection include antibiotic-impregnated catheters, protocol-based surgery, and shunt reservoir antibiotic injection. METHODS: An Institutional Review Board-approved retrospective review was performed for all adult shunt surgeries performed from January 2000 to September 2013 at a single academic institution. Records were cross-indexed with hospital billing records to identify patients who received antibiotic injections and cross-referenced with a prospective infection control database of all surgical site infections. The primary outcome measure was shunt infection within 1 year of surgery. RESULTS: Five-hundred thirteen adult patients met inclusion criteria. Antibiotic reservoir injection was associated with a significantly lower rate of infection (2.6%) when compared with no injection (6.3%, P = 0.0455). The antibiotic injection group also included significantly more patients with infection risk factors than the control group (38.8% vs. 18.0%, P < 0.005). CONCLUSION: Antibiotic reservoir injection is an effective method of reducing shunt infections in adults when combined with standard infection control measures.