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Shortening the perioperative prophylactic antimicrobial duration in pediatric ventriculoperitoneal (VP) shunt insertion
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DOI：10.1111/ped.70372.png)
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Abstract
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Background Perioperative antimicrobial therapy is important to prevent central nervous system (CNS) infections following cerebrospinal fluid (CSF) shunt insertion, but the optimal duration remains unclear. This study aimed to evaluate the incidence of ventriculoperitoneal (VP) shunt-associated CNS infection before and after the revision of the institutional protocol for discontinuing antimicrobial therapy within 48 h after surgery.Methods Patients aged 15 years or less who underwent VP shunt insertion at Tokyo Metropolitan Children's Medical Center between April 2014 and November 2021 were enrolled retrospectively. The primary outcome was the incidence of VP shunt-associated CNS infection at postoperative months 1 and 6 in pre- and post-intervention patient groups.Results Of the 117 patients screened, 27 were excluded. Of the eligible patients, 39 were in the pre-intervention group, and 51 were in the post-intervention group. The incidence of VP shunt-associated CNS infection at month 1 was 7.7% (3/39) in the pre-intervention group and 7.8% (4/51) in the post-intervention group (p = 0.98), with no significant difference. At month 6, the incidence was 7.7% (3/39) in the pre-intervention group and 13.7% (7/51) in the post-intervention group (p = 0.37), also not significantly different.Conclusions Reducing the duration of antibiotic prophylaxis for VP shunt insertion to within 48 h did not increase the incidence of VP shunt-associated CNS infection.
Keywords:
antibiotic stewardship
duration
pediatrics
prophylactic antibiotic
shunt infection
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