Rifampin-impregnated silicone catheters: a potential tool for prevention and treatment of CSF shunt infections.
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.
Hampl
J A
JA
Department of Neurosurgery,University of Cologne, Joseph-Stelzmann Strasse 9, D-50924 Cologne, Germany. juergen.hampl@medizin.uni-koeln.de
Weitzel
A
A
Bonk
C
C
Kohnen
W
W
Roesner
D
D
Jansen
B
B
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
D000900:Anti-Bacterial Agents; D012828:Silicones; D012293:Rifampin