Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: We will examine the following hypotheses: (1) the incidence of shunt infection is less frequent with administration of systemic antibiotics beginning previously or at the time of the surgical procedure; (2) the incidence of shunt infection is less frequent when antibiotic‐impregnated shunt systems are used, considering that the eventual regimen of systemic antibiotics applied is the same. We will perform separate analyses for systemic antibiotics and antibiotic‐impregnated systems. To test these hypotheses a literature review with the following objectives will be carried out: Primary objective We will establish the effectiveness and safety of the use of prophylactic antibiotics, whether systemic or catheter‐impregnated, for intracranial ventricular shunts. We will separately analyse external and internal intracranial shunts. Secondary Objectives If sufficient relevant information is available, we will perform the following subgroup analysis: (1) to determine the differences in infectious risk of external ventricular shunts versus internal ventricular shunts; (2) to determine the differences in infectious risk of ventriculoperitoneal shunts versus ventriculoatrial shunts; (3) to determine the differences in infectious risk in children versus adults (above 18 years old); (4) to determine the differences in infectious risk in using periprocedural antibiotics versus continuous antibiotics.