Ahead of Print: Silver-Impregnated Line Vs EVD Randomized Trial

Background: Cerebrospinal fluid (CSF) infections associated with external ventricular drain (EVD) placement attract major consequences. Silver impregnation of catheters attempts to reduce infection.

Objective: To assess the efficacy of silver catheters against CSF infection.

Methods: We performed a randomized controlled trial involving two neurosurgical centers (June 2005 to September 2009). 356 patients requiring an EVD were assessed for eligibility; 325 patients were enrolled and randomized (167 plain, 158 silver). 278 patients were analyzed (140 plain, 138 silver). The primary outcome measure was CSF infection as defined by organisms seen on gram stain or isolated by culture. Secondary outcome measures included ventriculo-peritoneal (VP) shunting.