{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:33:16Z","timestamp":1787027596562,"version":"build-2736575974"},"reference-count":86,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,26]],"date-time":"2022-06-26T00:00:00Z","timestamp":1656201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Pediatric neurosurgery is a highly specialized branch of surgery in which surgical site infections (SSIs) are potentially serious complications that can also adversely affect a good surgical outcome, compromising functional recovery and, in some cases, even putting the patient\u2019s life at risk. The main aim of this consensus document is to provide clinicians with a series of recommendations on antimicrobial prophylaxis for neonates and children undergoing neurosurgery. The following scenarios were considered: (1) craniotomy or cranial\/cranio-facial approach to craniosynostosis; (2) neurosurgery with a trans-nasal-trans-sphenoidal approach; (3) non-penetrating head injuries; (4) penetrating head fracture; (5) spinal surgery (extradural and intradural); (6) shunt surgery or neuroendoscopy; (7) neuroendovascular procedures. Patients undergoing neurosurgery often undergo peri-operative antibiotic prophylaxis, with different schedules, not always supported by scientific evidence. This consensus provides clear and shared indications, based on the most updated literature. This work has been made possible by the multidisciplinary contribution of experts belonging to the most important Italian scientific societies, and represents, in our opinion, the most complete and up-to-date collection of recommendations on the behavior to be held in the peri-operative setting in this type of intervention, in order to guide physicians in the management of the patient, standardize approaches and avoid abuse and misuse of antibiotics.<\/jats:p>","DOI":"10.3390\/antibiotics11070856","type":"journal-article","created":{"date-parts":[[2022,6,26]],"date-time":"2022-06-26T09:00:13Z","timestamp":1656234013000},"page":"856","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Surgical Antimicrobial Prophylaxis in Neonates and Children Undergoing Neurosurgery: A RAND\/UCLA Appropriateness Method Consensus Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Susanna","family":"Esposito","sequence":"first","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7494-355X","authenticated-orcid":false,"given":"Mino","family":"Zucchelli","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bianchini","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Nicoletti","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Monaco","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Rigotti","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Venditto","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Auriti","sequence":"additional","affiliation":[{"name":"Neonatology and Neonatal Intensive Care Unit, IRCCS Bambino Ges\u00f9 Children\u2019s Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3196-2435","authenticated-orcid":false,"given":"Caterina","family":"Caminiti","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5336-8429","authenticated-orcid":false,"given":"Elio","family":"Castagnola","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Conti","sequence":"additional","affiliation":[{"name":"Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario A. 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Control Hosp. Epidemiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1007\/s11096-021-01233-2","article-title":"Utilization of neurosurgical perioperative antimicrobial prophylaxis in a Chinese teaching hospital","volume":"43","author":"Zhang","year":"2021","journal-title":"Int. J. Clin. Pharm."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bianchini, S., Rigotti, E., Nicoletti, L., Monaco, S., Auriti, C., Castagnola, E., Castelli Gattinara, G., De Luca, M., Galli, L., and Garazzino, S. (2022). Surgical Antimicrobial Prophylaxis in Neonates and Children with Special High-Risk Conditions: A RAND\/UCLA Appropriateness Method Consensus Study. Antibiotics, 11.","DOI":"10.3390\/antibiotics11020246"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1089\/sur.2013.9999","article-title":"Clinical practice guidelines for antimicrobial prophylaxis in surgery","volume":"14","author":"Bratzler","year":"2013","journal-title":"Surg. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/jac\/dkv418","article-title":"The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children","volume":"71","author":"Versporten","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2020.9.FOCUS20703","article-title":"Pediatric neurosurgery during the COVID-19 pandemic: Update and recommendations from the Brazilian Society of Pediatric Neurosurgery","volume":"49","author":"Ballestero","year":"2020","journal-title":"Neurosurg. Focus"},{"key":"ref_7","unstructured":"Fitch, K., Bernstein, S.J., and Aguilar, M.D. (2001). The RAND\/UCLA Adeguateness Method User\u2019s Manual, The RAND Corporation."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1136\/bmj.309.6956.730","article-title":"Some observations on attempts to measure appropriateness of care","volume":"309","author":"Hicks","year":"1994","journal-title":"BMJ"},{"key":"ref_9","first-page":"974","article-title":"Intracranial suppuration: A modern decade of postoperative subdural empyema and epidural abscess","volume":"34","author":"Hlavin","year":"1994","journal-title":"Neurosurgery"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1086\/518580","article-title":"Postoperative central nervous system infection: Incidence and associated factors in 2111 neurosurgical procedures","volume":"45","author":"McClelland","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"761","DOI":"10.3171\/jns.1981.55.5.0761","article-title":"Subacute postoperative subdural empyema","volume":"55","author":"Post","year":"1981","journal-title":"J. Neurosurg."},{"key":"ref_12","first-page":"304","article-title":"Postoperative abscesses and empyemas. Apropos of 13 cases","volume":"32","author":"Rousseaux","year":"1986","journal-title":"Neurochirurgie"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S0303-8467(97)00118-2","article-title":"Postoperative intracranialabscess\u2014Clinical aspects in the differential diagnosis to early recurrence of malignant glioma","volume":"100","author":"Vogelsang","year":"1998","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"720074","DOI":"10.3389\/fped.2021.720074","article-title":"The Influence of Perioperative Antibiotic Prophylaxis on Wound Infection and on the Colonization of Wound Drains in Patients After Correction of Craniosynostosis","volume":"9","author":"Holle","year":"2021","journal-title":"Front. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/SCS.0000000000005695","article-title":"Infectious Complications after Open Cranial Vault Remodeling for Craniosynostosis","volume":"31","author":"Musavi","year":"2020","journal-title":"J. Craniofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s10143-014-0524-z","article-title":"Antibiotic prophylaxis in craniotomy: A review","volume":"37","author":"Liu","year":"2014","journal-title":"Neurosurg. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0140-6736(47)92170-3","article-title":"Penicillin in the prevention of infection during operations on the brain and spinal cord","volume":"2","author":"Pennybacker","year":"1947","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1056\/NEJM195811272592201","article-title":"Complication rate in general surgical cases; the value of penicillin and streptomycin as postoperative prophylaxis; a study of 511 cases","volume":"259","author":"Fernand","year":"1958","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1001\/archsurg.1962.01310030104015","article-title":"Postoperative wound infection. A controlled study of antibiotic prophylaxis","volume":"85","author":"Rocha","year":"1962","journal-title":"Arch. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"125","DOI":"10.3171\/jns.1966.25.2.0125","article-title":"A survey of possible etiologic agents in postoperative craniotomy infections","volume":"25","author":"Wright","year":"1966","journal-title":"J. Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.wneu.2016.02.048","article-title":"The Efficacy of Antibacterial Prophylaxis Against the Development of Meningitis After Craniotomy: A Meta-Analysis","volume":"90","author":"Alotaibi","year":"2016","journal-title":"World Neurosurg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1227\/01.NEU.0000255425.31797.23","article-title":"Efficacy of prophylactic antibiotics against meningitis after craniotomy: A metaanalysis","volume":"60","year":"2007","journal-title":"Neurosurgery"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13756-020-00784-9","article-title":"Indirect comparison of efficacy between different antibiotic prophylaxis against the intracranial infection after craniotomy","volume":"9","author":"Cao","year":"2020","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Centers for Disease Control and Prevention (1996). National Nosocomial Infections Surveil-lance (NNIS) report, data summary from October 1986\u2013April 1996, issued May 1996. A report from the National Nosocomial Infections Surveillance (NNIS) System. Am. J. Infect. Control., 24, 380\u2013388.","DOI":"10.1016\/S0196-6553(96)90026-7"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"American Society of Health-System Pharmacists (1999). ASHP therapeutic guidelines on antimicrobial prophylaxis in surgery. Am. J. Health-Syst. Pharm., 56, 466\u2013513.","DOI":"10.1093\/ajhp\/56.18.1839"},{"key":"ref_26","first-page":"2049","article-title":"Optimaliseren van het antibioticabeleid in Nederland. V. SWAB-richtlijnen voor perioperatieve antibiotische profylaxe","volume":"144","author":"Gyssens","year":"2000","journal-title":"Ned. Tijdschr. Geneeskd."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e534","DOI":"10.1016\/j.wneu.2018.07.200","article-title":"Effect of Staphylococcal Decolonization Regimen and Change in Antibiotic Prophylaxis Regimen on Incidence of Postcraniotomy Aseptic Meningitis","volume":"119","author":"Gupta","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1016\/j.otsr.2020.01.013","article-title":"Individual decontamination measures reduce by two the incidence of surgical site infections in spinal surgery","volume":"106","author":"Bouyer","year":"2020","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_29","unstructured":"Chen, A.F., Farber, N.J., Zammerilla, L.L., Nowicki, A.L., Rao, N., Kang, J.D., Lee, J.Y., and Donaldson, W.F. (2013, January 2\u20133). Preoperative Staphylococcus Decolonization in Elective Spine Cases is Effective. Proceedings of the MSIS Annual Meeting Program 2013, Rochester, MN, USA."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1007\/s00381-021-05095-x","article-title":"Prevention of surgical site infections in pediatric spines: A single-center experience","volume":"37","author":"Solla","year":"2021","journal-title":"Childs Nerv. Syst."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"805966","DOI":"10.3389\/fphar.2022.805966","article-title":"Vancomycin, Daptomycin, Antistaphylococcal \u03b2-Lactam, and Trimethoprim-Sulfamethoxazole Monotherapy and Combination Therapy in the Management of Methicillin-Resistant Staphylococcus aureus: A Network Meta-Analysis","volume":"13","author":"Xu","year":"2022","journal-title":"Front. Pharmacol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1227\/01.neu.0000316256.44349.b1","article-title":"Risk factors for adult nosocomial meningitis after craniotomy: Role of antibiotic prophylaxis","volume":"62","author":"Korinek","year":"2008","journal-title":"Neurosurgery"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1007\/s40262-017-0548-y","article-title":"Penetration of Vancomycin into the Cerebrospinal Fluid: A Systematic Review","volume":"56","author":"Beach","year":"2017","journal-title":"Clin. Pharmacokinet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s11102-011-0359-3","article-title":"Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of giant pituitary adenomas","volume":"15","author":"Komotar","year":"2012","journal-title":"Pituitary"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.wneu.2019.10.039","article-title":"Outcome of endoscopic endonasal surgery in pediatric craniopharyngiomas","volume":"134","author":"Mazzatenta","year":"2020","journal-title":"World Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.2176\/nmc.oa.2014-0129","article-title":"Analysis of the bacterial flora in the nasal cavity and the sphenoid sinus mucosa in patients operated on with an endoscopic endonasal transsphenoidal approach","volume":"54","author":"Shibao","year":"2014","journal-title":"Neurol. Med. Chir."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jocn.2014.08.009","article-title":"Risk factors for postoperative cerebrospinal fluid leak and meningitis after expanded endoscopic endonasal surgery","volume":"22","author":"Ivan","year":"2015","journal-title":"J. Clin. Neurosci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s11102-010-0256-1","article-title":"Prophylactic antibiotic trends in transsphenoidal surgery for pituitary lesions","volume":"14","author":"Little","year":"2011","journal-title":"Pituitary"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.wneu.2017.07.075","article-title":"Antibiotic Prophylaxis in Endoscopic Endonasal Pituitary and Skull Base Surgery","volume":"106","author":"Milanese","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.clineuro.2015.10.007","article-title":"Efficacy of ultra-short single agent regimen antibiotic chemoprophylaxis in reducing the risk of meningitis in patients undergoing endoscopic endonasal transsphenoidal surgery","volume":"139","author":"Somma","year":"2015","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s00701-020-04560-x","article-title":"Ultra-short antibiotic prophylaxis guided by preoperative microbiological nasal swabs in endoscopic endonasal skull base surgery","volume":"163","author":"Ceraudo","year":"2021","journal-title":"Acta Neurochir."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3171\/2014.5.PEDS13414","article-title":"Pediatric skull fractures: The need for surgical intervention, characteristics, complications, and outcomes","volume":"14","author":"Bonfield","year":"2014","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/BF00301021","article-title":"Pediatric depressed skull fractures: Analysis of 530 cases","volume":"12","author":"Ersahin","year":"1996","journal-title":"Child Nerv. Syst."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1007\/s00268-001-0059-7","article-title":"Post-traumatic cerebrospinal fluid leakage","volume":"25","author":"Friedman","year":"2001","journal-title":"World J. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1097\/00005373-200108001-00009","article-title":"Antibiotic prophylaxis for penetrating brain injury","volume":"51","author":"Pruitt","year":"2001","journal-title":"J. Trauma"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1227\/00006123-198310000-00005","article-title":"Air sinus wounds: An analysis of 163 consecutive cases incurred in the Korean War, 1950\u20131952","volume":"13","author":"Arendall","year":"1983","journal-title":"Neurosurgery"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3171\/jns.1981.54.1.0044","article-title":"Cerebrospinal fluid fistulas complicating missile wounds of the brain","volume":"54","author":"Meirowsky","year":"1981","journal-title":"J. Neurosurg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1016\/S0140-6736(00)02275-3","article-title":"Use of antibiotics in penetrating craniocerebral injuries. \u201cInfection in Neurosurgery\u201d Working Party of British Society for Antimicrobial Chemotherapy","volume":"355","author":"Bayston","year":"2000","journal-title":"Lancet"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"105777","DOI":"10.1016\/j.clineuro.2020.105777","article-title":"Evaluation of prophylactic antibiotics in penetrating brain injuries at an academic level 1 trauma center","volume":"193","author":"Marut","year":"2020","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_50","first-page":"E264","article-title":"Postoperative infections of the spine","volume":"40","author":"Bible","year":"2011","journal-title":"Am. J. Orthop."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1007\/s00586-021-07050-5","article-title":"Local vancomycin therapy to reduce surgical site infection in adult spine surgery: A randomized prospective study","volume":"31","author":"Salimi","year":"2022","journal-title":"Eur. Spine J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jocn.2018.03.023","article-title":"Prophylaxis of surgical site infection in adult spine surgery: A systematic review","volume":"52","author":"Yao","year":"2018","journal-title":"J. Clin. Neurosci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1016\/j.spinee.2019.05.592","article-title":"The efficacy of intrawound vancomycin powder and povidone-iodine irrigation to prevent surgical site infections in complex instrumented spine surgery","volume":"19","author":"Lemans","year":"2019","journal-title":"Spine J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"E709","DOI":"10.36076\/ppj.2021.24.E709","article-title":"Efficacy of Intrawound Treatments to Prevent Surgical Site Infection after Spine Surgery: A Systematic Review and Network Meta-analysis","volume":"24","author":"Lin","year":"2021","journal-title":"Pain Physician"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.surneu.2007.08.017","article-title":"Single-dose vs multiple-dose antibiotic prophylaxis in instrumented lumbar fusion\u2014A prospective study","volume":"70","author":"Hellbusch","year":"2008","journal-title":"Surg. Neurol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jhin.2019.04.017","article-title":"Antibiotic prophylaxis in spine surgery: A comparison of single-dose and 72-hour protocols","volume":"103","author":"Maciejczak","year":"2019","journal-title":"J. Hosp. Infect."},{"key":"ref_57","unstructured":"Hills, T., Crusz, S., Dow, G., and Dowdeswell, L. (2022, February 05). Neurosurgery Antibiotic Prophylaxis Guideline for Adult and Paediatric Patients. Guidelines of the Scottish Intercollegiate Guidelines Network (SIGN) Nottingham Antibiotic Guidelines Committee. Available online: https:\/\/www.nuh.nhs.uk\/download.cfm?doc=docm93jijm4n655.pdf&ver=4805."},{"key":"ref_58","unstructured":"European Centre for Disease Prevention and Control (2022, February 05). Systematic Review and Evidence-Based Guidance on Perioperative Antibiotic Prophylaxis. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/systematic-review-and-evidence-based-guidance-peri-operative-antibiotic."},{"key":"ref_59","unstructured":"North American Spine Society (2022, February 05). Evidenced-Base Clinical Guidelines for Multidisciplinary Spine Care. Available online: https:\/\/www.spine.org\/Portals\/0\/assets\/downloads\/ResearchClinicalCare\/Guidelines\/AntibioticProphylaxis.pdf."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1159\/000508753","article-title":"High Prevalence of Gram-Negative Rod and Multi-Organism Surgical Site Infections after Pediatric Complex Tethered Spinal Cord Surgery: Preliminary Report from a Single-Center Study","volume":"55","author":"Alexiades","year":"2020","journal-title":"Pediatr. Neurosurg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1086\/502259","article-title":"Surgical-site infection following spinal fusion: A case-control study in a children\u2019s hospital","volume":"24","author":"Demers","year":"2003","journal-title":"J. Infect. Control. Hosp. Epidemiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/BRS.0b013e3181c47f0f","article-title":"Complications of spinal fusion for Scheuermann kyphosis: A report of the Scoliosis Research Society Morbidity and Mortality Committee","volume":"35","author":"Coe","year":"2010","journal-title":"Spine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1097\/INF.0b013e31816fca72","article-title":"Timing of preoperative antibiotic prophylaxis: A modifiable risk factor for deep surgical site infections after pediatric spinal fusion","volume":"27","author":"Milstone","year":"2008","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1086\/593952","article-title":"Risk factors associated with surgical site infection after pediatric posterior spinal fusion procedure","volume":"30","author":"Linam","year":"2009","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00701-002-1068-5","article-title":"CSF shunt infections in children: Experiences from a population-based study","volume":"145","author":"Enger","year":"2003","journal-title":"Acta Neurochir."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"627","DOI":"10.3171\/jns.2004.101.4.0627","article-title":"Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: Predictors of treatment response and an analysis of long-term outcomes","volume":"101","author":"McGirt","year":"2004","journal-title":"J. Neurosurg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.wneu.2011.10.034","article-title":"Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: Long-term single institution experience","volume":"78","author":"Reddy","year":"2012","journal-title":"World Neurosurg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1227\/01.NEU.0000146206.40375.41","article-title":"Implanted ventricular shunts in the United States: The billion-dollar-a-year cost of hydrocephalus treatment","volume":"56","author":"Patwardhan","year":"2005","journal-title":"Neurosurgery"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1086\/501572","article-title":"The impact of surgical-site infections in the 1990s: Attributable mortality, excess length of hospitalization, and extra costs","volume":"20","author":"Kirkland","year":"1999","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_70","first-page":"87","article-title":"Antibiotic prophylaxis for cerebrospinal fluid shunts: A metanalysis","volume":"34","author":"Haines","year":"1994","journal-title":"Neurosurgery"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1093\/clinids\/17.1.98","article-title":"Efficacy of antimicrobial prophylaxis in placement of cerebrospinal fluid shunts: Meta-analysis","volume":"17","author":"Langley","year":"1993","journal-title":"Clin. Infect. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"48","DOI":"10.3171\/PED-08\/01\/048","article-title":"Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts: A systematic review","volume":"1","author":"Ratilal","year":"2008","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00381-015-2937-6","article-title":"Antibiotic prophylaxis for shunt surgery of children: A systematic review","volume":"32","author":"Xu","year":"2016","journal-title":"Childs Nerv. Syst."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3171\/2014.7.PEDS14326","article-title":"Pediatric hydrocephalus:systematic literature review and evidence-based guidelines. Part 6, Preoperative antibiotics for shunt surgery in children with hydrocephalus: A systematic review and meta-analysis","volume":"14","author":"Klimo","year":"2014","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_75","first-page":"CD012902","article-title":"Route of antibiotic prophylaxis for prevention of cerebrospinal fluid-shunt infection","volume":"6","author":"Arts","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1007\/s00381-018-3864-0","article-title":"Prophylactic antibiotics in pediatric neurological surgery","volume":"34","year":"2018","journal-title":"Childs Nerv. Syst."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s00381-018-3894-7","article-title":"Neuroendoscopic lavage for the treatment of CSF infection with hydrocephalus in children","volume":"34","author":"Gaderer","year":"2018","journal-title":"Childs Nerv. Syst."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s00381-021-05437-9","article-title":"Analysis of complications in intraventricular neuroendoscopy in children: Proposal for a standardization system","volume":"38","year":"2022","journal-title":"Childs Nerv. Syst."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1093\/neuros\/nyaa434","article-title":"Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Treatment of Pediatric Hydrocephalus: Update of the 2014 Guidelines","volume":"87","author":"Bauer","year":"2020","journal-title":"Neurosurgery"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1227\/NEU.0b013e31827d0ff7","article-title":"Infection risk in neurointervention and cerebral angiography","volume":"72","author":"Kelkar","year":"2013","journal-title":"Neurosurgery"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"797","DOI":"10.3171\/2018.10.JNS182540","article-title":"Infection risk in endovascular neurointerventions: A comparative analysis of 549 cases with and without prophylactic antibiotic use","volume":"132","author":"Burkhardt","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"107100","DOI":"10.1016\/j.clineuro.2021.107100","article-title":"Technical description of a novel device for external ventricular drainage in neonatal and pediatric patients: Results from a single referral center experience","volume":"213","author":"Consales","year":"2022","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2502","DOI":"10.1111\/bcp.14657","article-title":"Population pharmacokinetics of vancomycin in patients with external ventricular drain-associated ventriculitis","volume":"87","author":"Jalusic","year":"2021","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Cheng, Y.K., and Liu, C.L. (2022). Antibiotic-impregnated external ventricular drainage for the management of post-hemorrhagic hydrocephalus in low birth weight premature infants following intraventricular hemorrhage. Childs Nerv. Syst.","DOI":"10.1007\/s00381-022-05542-3"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/2016.1.PEDS15563","article-title":"Introduction of percutaneous-tunneled transfontanellar external ventricular drainage in the management of hydrocephalus in extremely low-birth-weight infants","volume":"18","author":"Zucchelli","year":"2016","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1186\/s12913-015-1130-7","article-title":"A method for measuring individual research productivity in hospitals: Development and feasibility","volume":"15","author":"Caminiti","year":"2015","journal-title":"BMC Health Serv. 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