The British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts multi-centre randomised controlled trial (the BASICS trial): study protocol

Jenkinson, Michael D ORCID: 0000-0003-4587-2139, Gamble, Carrol ORCID: 0000-0002-3021-1955, Hartley, John C, Hickey, Helen ORCID: 0000-0003-0467-0362, Hughes, Dyfrig ORCID: 0000-0001-8247-7459, Blundell, Michaela ORCID: 0000-0002-7772-271X, Griffiths, Michael J, Solomon, Tom ORCID: 0000-0001-7266-6547 and Mallucci, Conor L ORCID: 0000-0002-5509-0547 (2014) The British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts multi-centre randomised controlled trial (the BASICS trial): study protocol. TRIALS, 15 (1). 4-.

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Abstract

<h4>Background</h4>Insertion of a ventriculoperitoneal shunt (VPS) for the treatment of hydrocephalus is one of the most common neurosurgical procedures in the UK, but failures caused by infection occur in approximately 8% of primary cases. VPS infection is associated with considerable morbidity and mortality and its management results in substantial cost to the health service. Antibiotic-impregnated (rifampicin and clindamycin) and silver-impregnated VPS have been developed to reduce infection rates. Whilst there is some evidence showing that such devices may lead to a reduction in VPS infection, there are no randomised controlled trials (RCTs) to support their routine use.<h4>Methods/design</h4>Overall, 1,200 patients will be recruited from 17 regional neurosurgical units in the UK and Ireland. Patients of any age undergoing insertion of their first VPS are eligible. Patients with previous indwelling VPS, active and on-going cerebrospinal fluid (CSF) or peritoneal infection, multiloculated hydrocephalus requiring multiple VPS or neuroendoscopy, and ventriculoatrial or ventriculopleural shunt planned will be excluded. Patients will be randomised 1:1:1 to either standard silicone (comparator), antibiotic-impregnated, or silver-impregnated VPS. The primary outcome measure is time to VPS infection. Secondary outcome measures include time to VPS failure of any cause, reason for VPS failure (infection, mechanical failure, or patient failure), types of bacterial VPS infection (organism type and antibiotic resistance), and incremental cost per VPS failure averted.<h4>Discussion</h4>The British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts multi-centre randomised controlled trial (the BASICS trial) is the first multi-centre RCT designed to determine whether antibiotic or silver-impregnated VPS reduce early shunt infection compared to standard silicone VPS. The results of this study will be used to inform current neurosurgical practice and may potentially benefit patients undergoing shunt surgery in the future.<h4>Trial registration</h4>International Standard Randomised Controlled Trial Number: ISRCTN49474281.

Item Type:	Article
Uncontrolled Keywords:	Ventriculoperitoneal shunt, Infection, Clinical trial, Antibiotic-impregnated, Silver-impregnated
Depositing User:	Symplectic Admin
Date Deposited:	22 Apr 2016 14:16
Last Modified:	15 Dec 2022 15:52
DOI:	10.1186/1745-6215-15-4
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3000536

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• The British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts multi-centre randomised controlled trial (the BASICS trial): study protocol. (deposited 23 Nov 2015 09:47)
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