Two consecutive series of patients operated for insertion or revision
of a shunt for hydrocephalus have been followed for at least 18 months
. The series are comparable. The first series (84 cases) did not recei
ve antibiotic prophylaxis, whereas the second series (59 cases) receiv
ed a unique dose of intravenous Vancomycin immediately before the oper
ation. In the first series (168 operations), there were 18 infections,
8 in the group of 34 children and 10 in the group of 50 adults. In th
e second series, only one infection happened in the group of 27 adults
(41 operations) and none among the 22 children (44 operations). The d
ifference was significative. Bacteriological samples were taken during
these operations. The positive cultures, mostly for sta. epidermidis,
were as frequent among the cases of the first series than among those
of the second series. The antibiotics are considered effective in pro
tecting the shunting device against contamination during the surgical
procedure by germs from the skin of the patient.