Evidence map›Paper›PMID 38734598›Full record

Observational studyBMC pediatrics2024

Antibiotic impregnated catheters and intrathecal antibiotics for CSF shunt infection prevention in children undergoing low-risk CSF shunt surgery.

Stacey Podkovik, Chuan Zhou, Susan E Coffin, Matthew Hall, Jason S Hauptman, Matthew P Kronman, Francesco T Mangano, Ian F Pollack, Sabrina Sedano, Joaquin Vega and 5 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in BMC pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Stacey PodkovikDepartment of Neurological Surgery, Riverside University Health Sciences Medical Center, Riverside, CA, USA.
Chuan ZhouCenter for Child Health, Seattle Children's Research Institute, Behavior, and Development, Seattle, WA, USA.
Susan E CoffinDepartment of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Matthew HallChildren's Hospital Association, Lenexa, KS, USA.
Jason S HauptmanDepartment of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, USA.
Matthew P KronmanDepartment of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.
Francesco T ManganoDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Ian F PollackDepartment of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Sabrina SedanoDivision of Hospital Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd,, MS 94, Los Angeles, CA, 90027, USA.
Joaquin VegaDivision of Hospital Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd,, MS 94, Los Angeles, CA, 90027, USA.
Joshua K SchaffzinFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Emily ThorellDepartment of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.
Benjamin C WarfDepartment of Neurosurgery, Harvard School of Medicine, Boston, MA, USA.
Kathryn B WhitlockNew Harmony Statistical Consulting, Clinton, WA, USA.
Tamara D SimonDivision of Hospital Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd,, MS 94, Los Angeles, CA, 90027, USA. tsimon@chla.usc.edu.

Funding

Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
Southern California Clinical and Translational Science InstituteUL1TR000130 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BUCHANAN, THOMAS A · 2012 to 2015
$36.0M
Prevention of Cerebrospinal Fluid (CSF) Shunt InfectionsR01NS101029 · NINDS · SEATTLE CHILDREN'S HOSPITAL · PI SIMON, TAMARA DANIELLE · 2018 to 2022
$2.2M
NCATS NIH HHS UL1 TR000130NCATS NIH HHS UL1 TR001855NINDS NIH HHS R01 NS101029
6 · The paper itself

Abstract

backgroundCerebrospinal fluid (CSF) shunts allow children with hydrocephalus to survive and avoid brain injury (J Neurosurg 107:345-57, 2007; Childs Nerv Syst 12:192-9, 1996). The Hydrocephalus Clinical Research Network implemented non-randomized quality improvement protocols that were shown to decrease infection rates compared to pre-operative prophylactic intravenous antibiotics alone (standard care): initially with intrathecal (IT) antibiotics between 2007-2009 (J Neurosurg Pediatr 8:22-9, 2011), followed by antibiotic impregnated catheters (AIC) in 2012-2013 (J Neurosurg Pediatr 17:391-6, 2016). No large scale studies have compared infection prevention between the techniques in children. Our objectives were to compare the risk of infection following the use of IT antibiotics, AIC, and standard care during low-risk CSF shunt surgery (i.e., initial CSF shunt placement and revisions) in children.

methodsA retrospective observational cohort study at 6 tertiary care children's hospitals was conducted using Pediatric Health Information System + (PHIS +) data augmented with manual chart review. The study population included children ≤ 18 years who underwent initial shunt placement between 01/2007 and 12/2012. Infection and subsequent CSF shunt surgery data were collected through 12/2015. Propensity score adjustment for regression analysis was developed based on site, procedure type, and year; surgeon was treated as a random effect.

resultsA total of 1723 children underwent initial shunt placement between 2007-2012, with 1371 subsequent shunt revisions and 138 shunt infections. Propensity adjusted regression demonstrated no statistically significant difference in odds of shunt infection between IT antibiotics (OR 1.22, 95% CI 0.82-1.81, p = 0.3) and AICs (OR 0.91, 95% CI 0.56-1.49, p = 0.7) compared to standard care.

conclusionIn a large, observational multicenter cohort, IT antibiotics and AICs do not confer a statistically significant risk reduction compared to standard care for pediatric patients undergoing low-risk (i.e., initial or revision) shunt surgeries.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisCerebrospinal Fluid ShuntsAdolescentCatheter-Related InfectionsCathetersCatheters, IndwellingChildChild, PreschoolFemaleHumansHydrocephalusInfantInjections, SpinalMaleRetrospective StudiesAnti-Bacterial AgentsAntibiotic impregnated catheterCSFHydrocephalusInfection

Identifiers

PMID38734598
PMCPMC11088062

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.