Researchers question use of antibiotic shunts in hydrocephalus patients

Led by neurosurgeon Dr. Benjamin Warf, a team of researchers from Boston Children’s Hospital published a study this month questioning the benefits of using shunts impregnated with antibiotics to treat hydrocephalus.

Hydrocephalus, which affects roughly 400,000 children each year, is characterized by fluid accumulation in the brain. Surgeons use shunts to drain the patient’s excess fluid and antibiotic shunts have become the standard of care in the U.S.

But these drug-laden devices are more expensive than their bare counterparts and the healthcare industry has collectively tried to limit the use of antibiotics in recent years.

Examining 248 children at the CURE Children’s Hospital in Uganda, researchers found no statistically significant difference in infection rate between children who received bare shunts and those who received antibiotic shunts.

Secondary outcomes, like death rate and reoperation, were also not statistically different between the two groups.

“The study fails to support the marketing of these much more expensive shunts to low-income countries where resources are scarce, although it is possible that efficacy could vary regionally with differences in the bacteria causing shunt infections,” Warf said, according to the Boston Children’s Hospital’s Vector blog.

“Clearly, though, for this population of infants in East Africa, the added cost cannot be justified. Furthermore, the use of these more expensive shunt products here in the U.S. lacks adequate scientific support, and the Ugandan study casts further doubt on the practice,” he added.

Want to stay on top of DDBN content? Sign up for our e-mail newsletter for a weekly dose of drug-device news.