MIETHKE XABO®

Antibiotic Impregnated Catheters – Xtra Protection Against Infection

One of the most common and potentially serious complications of hydrocephalus treatment is an infection of the shunt [1], affecting 7-15% of hydrocephalus patients [3]. This complication affects pediatric as well as adult patients and impairs their quality of life, cognitive function, and shunt survival [2]. Shunt infections mostly require removal of the shunt, antibiotic treatment and reimplantation [2].

Shunt infections can have severe consequences for the patient: They are associated with a higher risk for further complications, such as seizures, psychomotor retardation, and shunt failure, which increase morbidity and mortality [6–9]. For the neurosurgeon, shunt infections drastically increase the workload and in the worst-case scenario require additional unplanned surgeries.

Use of antibiotic-impregnated catheters can prevent two-thirds of shunt infections [11], thus helping to reduce patient burden and improve patient outcome.

MIETHKE’s new antibiotic-impregnated catheter XABO uses a balanced ratio of clindamycin hydrochloride and rifampicin to effectively fight gram-positive bacteria [12].

XABO antibiotic impregnated catheters offer long-lasting antimicrobial effects, easy handling, convenient storage and perfectly fit all our innovative MIETHKE valves. Patients can benefit from XABO’s optimized release kinetics: the antibiotics are released continuously over at least 38 days after implantation [14], ensuring that XABO’s antimicrobial activity covers the time window when the patient is most susceptible to infection [1, 15-17]. The high potency of the antibiotic impregnation allows for the release of low antibiotic doses, which prevents allergic reactions and minimizes the risk of resistance development.

XABO’s initial antibiotic loading is retained thanks to the gentle sterilization process. In addition, XABO comes wrapped in a specifically designed complete package combination that minimizes degradation products [13], ensuring the antibiotic-impregnated catheter is kept in prime condition for longer. Thanks to the gentle sterilization process and safe packaging it is storable for up to 36 months and withstands temperatures up to 30°C without losing its effectiveness [18].

Advantages

  • Effective against gram-positive bacteria
  • Continuously release antibiotics for at least 38 days
  • Fits to our innovative MIETHKE valves
  • Shelf life of up to 36 months
  • Withstand temperatures up to 30°C

Contact

Get in touch with our Neurosurgery experts >>

Note

The use of the antibiotics rifampicin and clindamycin hydrochloride may cause hypersensitivity.

Indication

Treatment of Hydrocephalus

[1] Okamura Y, Maruyama K, Fukuda S, et al. Detailed standardized protocol to prevent cerebrospinal fluid shunt infection. J Neurosurg 2019:1–5.

[2] Vinchon M, Dhellemmes P. Cerebrospinal fluid shunt infection: risk factors and long-term follow-up. Childs Nerv Syst 2006;22(7):692–97.

[3] Fernández-Méndez R, Richards HK, Seeley HM, et al. Current epidemiology of cerebrospinal fluid shunt surgery in the UK and Ireland (2004-2013). J Neurol Neurosurg Psychiatry 2019;90(7):747–54.

[6] Blount JP, Campbell JA, Haines SJ. Complications in Ventricular Cerebrospinal Fluid Shunting. Neurosurgery Clinics of North America 1993;4(4):633–56.

[7] Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med 2004;350(14):1422–29.

[8] Walters BC, Hoffman HJ, Hendrick EB, et al. Cerebrospinal fluid shunt infection. Influences on initial management and subsequent outcome. J Neurosurg 1984;60(5):1014–21.

[9] Sciubba DM, Stuart RM, McGirt MJ, et al. Effect of antibiotic-impregnated shunt catheters in decreasing the incidence of shunt infection in the treatment of hydrocephalus. J Neurosurg 2005;103(2 Suppl):131–36.

[10] Parker SL, McGirt MJ, Murphy JA, et al. Cost savings associated with antibiotic-impregnated shunt catheters in the treatment of adult and pediatric hydrocephalus. World Neurosurg 2015;83(3):382–86.

[11] Mallucci CL, Jenkinson MD, Conroy EJ, et al. Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation. The Lancet 2019;394(10208):1530–39.

[12] MIETHKE report. Data on file.

[13] MIETHKE report. Data on file.

[14] MIETHKE report. Data on file.

[15] Borgbjerg BM, Gjerris F, Albeck MJ, Børgesen SE. Risk of infection after cerebrospinal fluid shunt: an analysis of 884 first-time shunts. Acta Neurochir (Wien). 1995;136(1-2):1-7.

[16] George R, Leibrock L, Epstein M. Long-term analysis of cerebrospinal fluid shunt infections. A 25-year experience. J Neurosurg. 1979;51(6):804-811.

[17] Wells DL, Allen JM. Ventriculoperitoneal shunt infections in adult patients. AACN Adv Crit Care. 2013;24(1):6-14.

[18] MIETHKE report. Data on file.