Do patients with hydrocephalus shunts need antibiotic prophylaxis before undergoing dental procedures?

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Publisher: North West Medicines Information Centre

Keywords: Prophylaxis; Antibiotics; Hydrocephalus; Shunts-surgical

Date published: 26/02/2010 00:00

Review date: 30/11/2011 00:00

Summary

by: Christine Randall

Hydrocephalus is a neurological condition resulting from an accumulation of cerebrospinal fluid (CSF) which is managed by implanting a shunt system to remove the excess CSF.
There are two types of shunt system; ventriculo-atrial (VA) which discharges CSF into the right atrium and ventriculo-peritoneal (VP) which discharges CSF into the peritoneum.
There have been no randomised controlled trials evaluating the use of antibiotic prophylaxis to prevent secondary infection from a distant source, including the mouth, in patients with VP or VA shunts.
The risk of CSF shunt infection following dental procedures appears to be almost negligible. There are no reported cases of CSF shunt infection following a dental procedure. There is no evidence that S.viridans bacteria isolated from CSF shunt infections have been of oral origin.
There are risks associated with use of antibiotic prophylaxis.
On this basis, patients who have either a VP or VA shunt do not require antibiotic prophylaxis prior to dental procedures to prevent shunt infections.

About this library entry

Category: 5.1 Antibacterial drugs | Dentistry

NeLM area: Evidence > Medicines Q & A