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Materials and methods We describe analysis of data stored in two computer databases for 2,193 shunt related operations involving 786 patients. Infections were defined as positive cultures of the CSF or the shunt. Antibiotic levels in the CSF and Minimam Bacteriocidal (MBC) levels are expressed in ug/ml. Operative procedures were complete shunt removal, placement of an extra ventricular drain, antibiotics until the CSF was sterile, then replacement of the shunt ((CSR+EVD+abx+R), externalization of the distal limb, abx, then R (Ex+abx+R) and antibiotics alone. Analysis was by transfer to Excel files, Fisher Exact and Student ttests. A cure was defined as 16 months without recurrent infection or a new infection with another organism.

Comprehensive, economical management of cerebrospinal fluid shunt infections – a twenty-one year experience