CSF/shunt infections--the bane of our lives!

Thirty one patients were treated for 43 laboratory proven shunt or CSF infections, between 1980 to 1986 inclusive. They required 63 separate treatments. Infective episodes were grouped retrospectively according to method of treatment employed i.e. 1) placement of external drainage system or 2) reservoir and tapping, 3) intravenous or intraventricular antibiotics alone, 4) total change of shunt prosthesis, 5) partial change of prosthesis or 6) removal of all the prosthesis. See Table II. The single most important factor in eradication of shunt infection was the entire removal of the total shunt system and achieved success in 80% of instances. Conversely utilization of any of the existing infected system failed in 77% of cases. Route of administration of antibiotics, choice or change of side, or method of treatment chosen did not appear to influence success greatly.