An evaluation of the epileptogenic properties of a rifampicin/clindamycin-impregnated shunt catheter.
A process has been developed by which ventriculoperitoneal hydrocephalus shunts, which are prone to bacterial colonisation, can be impregnated with antimicrobials in order to confer antibacterial activity. Concern that their use might be associated with an increased risk of postoperative seizures has been addressed here. Using two rat models, namely pentylenetetrazole (PTZ) and maximal electroconvulsive seizure (ECS) thresholds, the possible epileptogenic characteristics of the shunt catheters were determined. Animals implanted with impregnated catheters exhibited no significant difference in PTZ seizure threshold compared with controls. In contrast, the ECS threshold test showed an enhancement in seizure susceptibility in the non-impregnated catheter group, in accordance with that found in human subjects, but a significant reduction in the impregnated catheter group at 2 and 28 days, postoperatively. These data suggest that the use in human subjects of shunts impregnated with these antimicrobials will not increase the risk of postoperative seizures.
Abed
W T
WT
University Department of Clinical Neurology, University of London, UK.
Alavijeh
M S
MS
Bayston
R
R
Shorvon
S D
SD
Patsalos
P N
PN
D000818:Animals; D002981:Clindamycin / Q000009:adverse effects* / Q000627:therapeutic use*; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D010433:Pentylenetetrazole; D051381:Rats; D017207:Rats, Sprague-Dawley; D012293:Rifampin / Q000009:adverse effects* / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000150:complications* / Q000188:drug therapy* / Q000517:prevention & control; D017287:Ventriculoperitoneal Shunt
D002981:Clindamycin; D012293:Rifampin; D010433:Pentylenetetrazole