Efficacy of Prophylactic Use of Ceftriaxone and Flucloxacillin Combination Therapy to Prevent Early Infection in Ventriculoperitoneal Shunt Surgery: A Randomized Controlled Trial
DOI:
https://doi.org/10.31344/ijhhs.v10i3.955Keywords:
Antibiotics, combination therapy, hydrocephalus, prophylaxis, ventriculoperitoneal shunt, shunt infectionAbstract
Shunt infection is a dangerous complication of ventriculoperitoneal (VP) shunt surgery. Many factors have been identified, which causes shunt infection. Prophylactic antibiotics have been used for prevention of early shunt infection. A prospective, randomized controlled trial (RCT) was conducted in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), between July 2008 and May 2010, to compare the efficacy of the combination of ceftriaxone and gentamicin with the combination of ceftriaxone and flucloxacillin in prevention of early infection in ventriculoperitoneal shunt surgery. A total of 30 patients were selected. Patients with preoperative fever or any other focus of infection, other medical problems e.g., diabetes mellitus, valvular heart disease, renal impairment and ruptured meningocele were excluded from the study. Patients who had previous cerebrospinal fluid (CSF) diversion surgery, e.g., endoscopic third ventriculostomy (ETV), external-ventricular drains (EVD), were also excluded from the study. They were further divided into two groups having 15 patients in each group. Control group (group A) received the combination of ceftriaxone and gentamicin. Case group (group B) received the combination of ceftriaxone and flucloxacillin. Indications of surgery were same for the both groups. All patients were given injectable (intravenous) antibiotics from the same manufacturer. Then they were followed up daily for infection for two weeks after the surgery. The patients aged between 2 months and 65 years, with a mean age of 19.9 years. Male-female ratio was 2:1. Out of the 30 patients, 7(23.3%) patients developed VP shunt infections. Out of them, 6 patients (in group A) received the combination of injection ceftriaxone and gentamicin, while only 1 received (in group B) the combination of injection ceftriaxone and flucloxacillin. The combination of ceftriaxone and flucloxacillin showed better prophylaxis in comparison to the combination of ceftriaxone and gentamicin (p<0.05).
International Journal of Human and Health Sciences Vol. 10 No. 03 Jul’26 Page: 164-168
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Copyright (c) 2026 Kaisar Haroon, Kanak Kanti Barua, Tania Taher, Md Shafiul Alam
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