title: Rifampin-impregnated silicone catheters: a potential tool for prevention and treatment of CSF shunt infections.
abstract: BACKGROUND
  Infection continues to be one of the major complications of cerebro-spinal fluid shunting procedures. Recent insights in the pathophysiological mechanism of these foreign body infections have elucidated the difficulty of achieving successful treatment without device removal. The development of a rifampin-impregnated silicone catheter yielded excellent results in infection prevention and treatment in vitro as well as in an animal model.
  
  
  METHODS
  Here, we describe the application of this device in two patients with a complicated course of shunt infection.
  
  
  RESULTS
  In one patient the rifampin-impregnated shunt system was implanted after external drainage to prevent further infection. The shunt infection of the second patient was treated by replacement of the infected shunt system with a rifampin-impregnated device. Both patients recovered immediately without any signs of adverse effects and the two shunt systems have now been working properly for more than 36 and 21 months, respectively.
  
  
  CONCLUSIONS
  These results suggest that rifampin-impregnated silicone catheters could become a valuable tool in the treatment and prevention of shunt infections.
authors.affiliation: Department of Neurosurgery,University of Cologne, Joseph-Stelzmann Strasse 9, D-50924 Cologne, Germany. juergen.hampl@medizin.uni-koeln.de
authors.forename: J A
authors.initials: JA
authors.lastname: Hampl
authors.forename: A
authors.initials: A
authors.lastname: Weitzel
authors.forename: C
authors.initials: C
authors.lastname: Bonk
authors.forename: W
authors.initials: W
authors.lastname: Kohnen
authors.forename: D
authors.initials: D
authors.lastname: Roesner
authors.forename: B
authors.initials: B
authors.lastname: Jansen
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002404:Catheterization / Q000295:instrumentation*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D012293:Rifampin / Q000008:administration & dosage* / Q000627:therapeutic use; D012828:Silicones / Q000737:chemistry; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D012828:Silicones; D012293:Rifampin