10
Treatment
Prevention
➤ Periprocedural prophylactic antimicrobial administration is
recommended for patients undergoing CSF shunt or drain insertion
(S-M).
➤ Periprocedural prophylactic antimicrobial administration is
recommended for patients undergoing placement of external
ventricular drains (S-M).
➤ Prolonged antimicrobial prophylaxis for the duration of the external
ventricular drain is of uncertain benefit and NOT recommended (S-M).
➤ Use of antimicrobial-impregnated CSF shunts and CSF drains is
recommended (S-M).
➤ In patients with external ventricular drains, fixed interval exchange is
NOT recommended (S-M).
➤ Use of a standardized protocol for insertion of CSF shunts and drains
is recommended (S-M).
Prophylactic Antimicrobial Therapy
➤ For neurosurgical patients, perioperative antimicrobial agents are
recommended to prevent infections of the incision (S-H).
➤ In patients with basilar skull fractures and a CSF leak, prophylactic
antimicrobial agents are NOT recommended (S-M).
➤ In patients with basilar skull fractures and a prolonged CSF leakage
(>7 days), an attempt to repair the leak is recommended (S-L).
➤ In patients with basilar skull fractures and a CSF leak, pneumococcal
vaccination is recommended (S-M).
