Overview
The length of prophylactic antibiotic use with antibiotic impregnated External Ventricular Drains (EVD)s is unknown. This study is a randomized clinical trial with two arms:
- twenty four hours of prophylactic antibiotic use or
- prophylactic antibiotic use for entire duration of EVD
Description
The principle objective of this study is to compare the incidence of ventriculostomy related infections (VRIs) in patients who receive twenty-four hours of antibiotics, beginning no more than sixty minutes prior to EVD placement, to the incidence of VRIs in patients who also receive a pre-procedural dose of antibiotics with continued dosing of antibiotics for the duration of the external ventricular drain (EVD).
Eligibility
Inclusion Criteria:
- patients over the age of 18 years and patients diagnosed with a subarachnoid hemorrhage, intracerebral hemorrhage or acute ischemic stroke who require an EVD for management of their underlying condition.
- In certain cases (a small minority), an EVD must be replaced due to failure (i.e.; blood clot interrupting flow). In such cases, patients will be re-dosed with antibiotics prior to catheter exchange in typical fashion, and continue in their previously randomized treatment group.
Exclusion Criteria:
- patients who underwent any intracranial procedure in the 30 days prior,
- patients who were on antibiotics within the week prior to admission,
- patients with leukopenia (<5000) at baseline,
- patients with signs of meningitis, ventriculitis or any other infection at presentation,
- patients who are pregnant or prisoners.
- patients aged < 18 years old