A Trial of Vancomycin for Prophylaxis of Infections after Neurosurgical Shunts

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Abstract
To the Editor: The reported rate of infection after placement of neurosurgical shunts ranges between 3 and 27 per cent.1 , 2 Various antibiotics have been used prophylactically in an attempt to reduce the infection rate. Some trials have reported a lower rate with prophylactic use of semisynthetic penicillins,3 4 5 whereas others report no effect.1 , 6 Bayston's report of a trial comparing cloxacillin, gentamicin, and placebo yielded inconclusive results.7 Odio et al. reported that a controlled trial of vancomycin prophylaxis was discontinued owing to adverse reactions, including hypotension.8 The Neurosurgical Service at the Children's Hospital of Philadelphia began using vancomycin prophylaxis for shunt procedures . . .

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