External drainage for ventricular infection following cerebrospinal fluid shunts

57 children with shunt-related ventricular infection were treated with external ventricular drainage and a combination of systemic and intraventricular antibiotics. For persistent infection or inadequate drainage volume the external ventricular drain was promptly changed. Cerebrospinal fluid cultures of 54 (95%) of the children became sterile within an average of 5.1 days. As soon as three consecutive 48-hour cultures of the cerebrospinal fluid were negative, the external ventricular drainage was removed and a new ventriculoperitoneal shunt was inserted. Provided that three consecutive 48-hour cultures of the cerebrospinal fluid were negative at the time of reinstitution of ventriculoperitoneal shunting, low cerebrospinal fluid glucose readings were not associated with any greater risk of recurrent infection than following primary ventriculoperitoneal shunting.