Efficacy of Extended Antibiotic Cover for Ventricular Drains in Preventing Infections

Background and Objective: Antimicrobials are essential in preventing infections during neurosurgical interventions. The primary and secondary objectives of this study are to determine the efficacy of extended antibiotic cover for ventricular drains in preventing infections and to determine the safety profile of extended antibiotic cover for ventricular drains in preventing infections, respectively. Materials and Methods: This is an observational cross-sectional study conducted in a tertiary care centre in Kerala (January, 2019 to June, 2023). Patients admitted under Department of Neurosurgery undergoing external ventricular drain insertion and willing for the study are selected. They are administered intravenous ceftriaxone 2 g as extended antibiotic cover before and after procedure till the desired duration of cerebrospinal fluid drainage. Any sign of development of immediate infection is observed which is confirmed by cerebrospinal fluid culture sensitivity report and other cerebrospinal fluid parameters. The sample size obtained in this study was 33. Data was analysed using SPSS version 20.00. Results: The study involved 33 patients with a female preponderance (72.7%). External ventricular drain was kept for an average of 10.32±4.603 days. The cerebrospinal fluid culture and sensitivity during drain in situ showed no growth (87.9%) and one case of Acinetobacter baumannii complex (3%). The cerebrospinal fluid culture and sensitivity following drain removal showed no growth (78.8%) and one case of Acinetobacter baumannii complex (3%). Conclusion: This study showed the use of high-end beta-lactams according to the antibiotic stewardship program for their use until the drain is removed and that there is no possibility for foci of infection. The post-operative period is often uneventful in optimizing such therapeutic need-based innovation.