Supplementary data table 2: Detailed data extracted from the eight studies included in the qualitative analysis

RefNo. / Total no. of children / Age (Months) / Gender / Study type / Category / Organism / Antimicrobial / Duration (days) / Surgery for infected shunt / Microbiological cure / Day of 1st negative culture / Clinical outcome
15 / 1 / <15 years / Nk / Cohort study / CoNS / CoNS / Vancomycin IV initially then IT vancomycin (1-10mg) added / 37 / Externalisation of shunt proximal to the valve / yes / Nk / Microbiological cure
18 / 1 / <18 years / Nk / Cohort study / CoNS / CoNS / Vancomycin IV / 46 / Shunt removal and EVD / Nk / Nk / Nk
18 / 1 / <18 years / Nk / Cohort study / CoNS / CoNS / Vancomycin IV / 38 / Shunt removal and EVD / Nk / Nk / Nk
18 / 1 / <18 years / Nk / Cohort study / CoNS / CoNS / Vancomycin IV / 16 / Shunt removal and EVD / Nk / Nk / Nk
18 / 1 / <18 years / Nk / Cohort study / CoNS / CoNS / Vancomycin IV / 30 / Shunt revision / Nk / Nk / Nk
18 / 1 / <18 years / Nk / Cohort study / CoNS / CoNS / Vancomycin, co-trimoxazole, rifampicin / Vancomycin x28 days, co-trimoxazole x 22 days, rifampicin x14 days / Shunt removal and EVD / Nk / Nk / Nk
18 / 1 / <18 years / Nk / Cohort study / CoNS / CoNS / Ceftazidime, vancomycin / 15 / None / Nk / Nk / Nk
14 / 1 / 6 / F / Refractory case / CoNS / MR S.epi / Linezolid IV (10mg/kg TDS) / 14 / Shunt removal and EVD / yes / 4 / Clinical cure
14 / 1 / 7 / M / Refractory case / CoNS / MR S.epi / Linezolid IV (10mg/kg TDS) / 20 / Shunt removal and EVD / yes / 3 / Clinical cure
14 / 1 / 36 / F / Refractory case / CoNS / MR S.epi / Linezolid IV (10mg/kg TDS) / 19 / Shunt retention / yes / 4 / Clinical cure
14 / 1 / 10 / F / Refractory case / CoNS / MR S. epi / Linezolid IV (10mg/kg TDS) / 14 / Shunt removal and EVD / yes / 2 / Clinical cure
20 / 1 / 8 / M / Cohort study / CoNS / S. epi / Vancomycin IV and IT / 28 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
20 / 1 / 6 / F / Cohort study / CoNS / S. epi / Vancomycin IV and IT / 30 / Shunt removal and EVD / yes / Nk / Microbiological cure
20 / 1 / 1 / F / Cohort study / CoNS / S. epi / Vancomycin IV and IT / 29 / Shunt removal and EVD / yes / Nk / Microbiological cure
20 / 1 / 4 / M / Cohort study / CoNS / S. epi / Vancomycin IV and IT / 21 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
20 / 1 / 73 / F / Cohort study / CoNS / S. epi / Vancomycin IV and IT / 26 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
19 / 1 / 3 years / M / Refractory case / CoNS / MR S.epi / teicoplanin IV (6mg/kg bolus then 12mg/kg/day continuous infusion) / 3 weeks / Not known / Nk / Nk / Clinical cure
19 / 1 / 13 years / F / Refractory case / CoNS / MR S.epi / teicoplanin IV (6mg/kg bolus then 12mg/kg/day continuous infusion) / 3 weeks / Not known / yes / 7 / Microbiological and clinical cure
20 / 1 / 61 / M / Cohort study / CoNS / S. epi / Ceftriaxone IV, gentamicin IT / 26 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
20 / 1 / 35 / F / Cohort study / CoNS / S. epi / Amoxicillin PO, gentamicin IT / 28 / Shunt removal and EVD / yes / Nk / Microbiological cure and died at 13 months
20 / 1 / 154 / M / Cohort study / CoNS / S. epi / Cefoxitin IV, teicoplanin IT / 20 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
20 / 1 / 1 / M / Cohort study / CoNS / S. epi / Vancomycin IV and IT / 28 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
18 / 1 / <18 years / Nk / Cohort study / CoNS / CoNS / Vancomycin IV, teicoplanin IV / Vancomycin x24 days, teicoplanin x20 days / Shunt removal and EVD / Nk / Nk / Nk
20 / 1 / 144 / M / Cohort study / Staph sp. / Staph spp / Ceftriaxone IV, gentamicin IT / 22 / Shunt removal and EVD / yes / Nk / Microbiological cure and died at 8 months
20 / 1 / 36 / F / Cohort study / Staph sp. / Staph spp., / Ceftriaxone IM, vancomycin IT / 23 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
14 / 1 / 8 / M / Refractory case / S. aureus / MRSA / Linezolid IV (10mg/kg TDS) / 21 / Shunt retention / yes / 3 / Clinical cure
18 / 1 / <18 years / Nk / Cohort study / S. aureus / MRSA / Vancomycin IV, rifampicin / Vancomycin x55 days, Rifampicin x31 days / Shunt removal and EVD / Nk / Nk / Nk
13 / 1 / 6 / M / Refractory case / S. aureus / S. aureus / Ciprofloxacin IV (10mg/kg/day) / 6 / Shunt retention / Nk / Nk / Clinical cure, no sequelae
13 / 1 / 3 / M / Refractory case / S. aureus / S. aureus / Ciprofloxacin IV (50mg/kg/day) / 4 / Shunt extraction / Nk / Nk / Died
13 / 1 / 6 / M / Refractory case / S. aureus / S. aureus / Ciprofloxacin IV (30mg/kg/day) / 15 / Shunt extraction / Nk / Nk / Clinical cure, no sequelae
13 / 1 / 3 / F / Refractory case / S. aureus / S. aureus / Ciprofloxacin IV (40mg/kg/day) / 19 / Shunt extraction / Nk / Nk / Clinical cure, no sequelae
15 / 1 / <15 years / NK / Cohort study / S. aureus / S.aureus / Vancomycin IV and later vancomycin IT (1-10mg) added (after 14 days of IV flucloxacillin) / Nk / Externalisation of shunt proximal to the valve / yes / 17 / Microbiological cure
20 / 1 / 4 / F / Cohort study / S. aureus / S.aureus / Vancomycin IV, netilmicin IT / 23 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
20 / 1 / 1 / M / Cohort study / S. aureus / S.aureus / Vancomycin IV and IT / 25 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
20 / 1 / 2 / M / Cohort study / S. aureus / S.aureus / IV cephalothin, gentamicin IT / 24 / Shunt removal and EVD / yes / Nk / Microbiological cure
20 / 1 / 12 / M / Cohort study / S. aureus / S.aureus / Vancomycin IV and IT / 27 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
15 / 1 / <15 years / Nk / Cohort study / Streptococcus spp. / B-haemolytic Strep / Cloxacillin IV, vancmycin IT (1-10mg) / Nk / Externalisation of shunt proximal to the valve / yes / Nk / Microbiological cure
13 / 1 / 6 / F / Refractory case / Streptococcus spp. / E. faecalis / Ciprofloxacin IV (20mg/kd/day) / 6 / Shunt extraction / Nk / Nk / Failure, relapse of meningitis
15 / 1 / <15 years / Nk / Cohort study / Streptococcus spp. / Enterococcus / Co-trimoxazole IV, vancomycin IT (1-10mg) / Nk / Externalisation of shunt proximal to the valve / yes / Nk / Microbiological cure
14 / 1 / 4 / F / Refractory case / Streptococcus spp. / VRE / Linezolid IV (10mg/kg TDS) / 21 / Shunt removal and EVD / yes / 6 / Clinical cure
13 / 1 / 3 / M / Refractory case / Gram-negative / Acinetobactercalcoaceticus / Ciprofloxacin IV (20mg/kg/day) / 18 / Shunt extraction / Nk / Nk / Clinical cure, no sequelae
18 / 1 / <18 years / Nk / Cohort study / Gram-negative / E. cloacae, Ps. flourescesns / Ceftizoxime and tobramycin / 12 / Shunt revision / Nk / Nk / Nk
15 / 1 / <15 years / Nk / Cohort study / Gram-negative / E.coli / Co-trimoxazole IV, gentamicin IT (1-4mg) / Nk / Externalisation of shunt proximal to the valve / yes / Nk / Microbiological cure
15 / 1 / <15 years / Nk / Cohort study / Gram-negative / E.coli / Cefuroxime IV, gentamicin IT (1-4mg) / Nk / Externalisation of shunt proximal to the valve / yes / Nk / Microbiological cure
20 / 1 / 12 / M / Cohort study / Gram-negative / E.coli / Ceftriaxone IV, gentamicin IT / 30 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
18 / 1 / <18 years / Nk / Cohort study / Gram-negative / ESBL positive E.coli / Meropenem, vancomycin / 23 / Shunt removal and EVD / Nk / Nk / Nk
16 / 7 / <10 years / Nk / Cohort study / Gram-negative / GNB / Aminoglycoside / Nk / Shunt removal and EVD / 2 of 7 / 4.5 (mean) / Clinical cure (7 of 7)
16 / 12 / <10 years / Nk / Cohort study / Gram-negative / GNB / Ceftriaxone primary therapy / Nk / Shunt removal and EVD / 12 of 12 / 2.3 (mean) / Microbiological and clinical cure (12 of 12)
16 / 5 / <10 years / Nk / Cohort study / Gram-negative / GNB / Ceftriaxone salvage therapy post aminoglycoside / Nk / Shunt removal and EVD / 5 of 5 / 1.8 (mean) / Microbiological and clinical cure (5 of 5)
16 / 2 / <10 years / Nk / Cohort study / Gram-negative / GNB / IV amikacin with IV 3rd gen cephalosporin / Nk / Shunt removal and EVD / 2 of 2 / 5 (mean) / Microbiological and clinical cure (2 of 2)
16 / 2 / <10 years / Nk / Cohort study / Gram-negative / GNB / Moxalactam / Nk / Shunt removal and EVD / 2 of 2 / 6.5 (mean) / Microbiological and clinical cure (2 of 2)
15 / 1 / <15 years / Nk / Cohort study / Gram-negative / H.influenazae / Cefotaxime IV (300mg/kg/day), gentamicin IT added at day 6 / Nk / Externalisation of shunt proximal to the valve / yes / Nk / Microbiological cure
15 / 1 / < 15 years / Nk / Cohort study / Gram-negative / K.pneumoniae / Meropenem IV (120mg/kg/day), gentamicin IT added at 2 weeks / Nk / Externalisation of shunt proximal to the valve / yes / 17 / Microbiological cure
15 / 1 / <15 years / Nk / Cohort study / Gram-negative / P.aeruginosa / Meropenem IV, gentamicin IT / Nk / Externalisation of shunt proximal to the valve / yes / 4 / Microbiological cure
17 / 1 / 2 / F / Case series / Gram-negative / P.aeruginosa / Chloramphenicol and gentamicin / 18 / VP shunt exchange / Nk / Nk / Clinical cure
17 / 1 / 3 / F / Case series / Gram-negative / P.aeruginosa / Meropenem / 13 / VP shunt exchange / Nk / Nk / Clinical cure
17 / 1 / 1 / F / Case series / Gram-negative / P.aeruginosa / Ceftazidime and gentamicin / 12 / VP shunt exchange / Nk / Nk / Clinical cure, hydrocephalus
13 / 1 / 2 / F / Refractory case / Mixed / Acinetobacter spp., S. epidermidis, / Ciprofloxacin IV (20mg/kg/day) / 11 / Shunt extraction / Nk / Nk / Clinical cure, no sequelae
19 / 1 / 6 years / M / Refractory case / Mixed / E. faecalis (and Acinetobacter) / teicoplanin IV (6mg/kg bolus then 12mg/kg/day continuous infusion) and imipenem IV 50mg/kg and Pefloxacine 20mg/kg) / 1 month / Not known / yes / 6 / Microbiological and clinical cure
20 / 1 / 5 / F / Cohort study / Mixed / Staph spp., Klebsiella spp / Ceftazidime IV, gentamicin IT / 29 / Shunt removal and EVD / yes / Nk / Microbiological cure and survival
18 / 1 / <18 years / Nk / Cohort study / Other / Bacillus cereus / Meropenem, Vancomycin / 30 / Shunt removal / Nk / Nk / Nk
18 / 1 / <18 years / Nk / Cohort study / Other / Candida tropicalis / Amphotericin B IV / 33 / Shunt removal and EVD / Nk / Nk / Nk
15 / 1 / <15 years / Nk / Cohort study / Other / P.acnes / Vancomycin IV and IT (1-10mg) / Nk / Externalisation of shunt proximal to the valve / yes / Nk / Microbiological cure

CoNS= Coagulase negative Staphylococcus, EVD = extraventricular, F = female, IV= intravenous, IT = intrathecal, M = male, MR S.epi= Meticillin resistant Staphylococcus epidermidis, MRSA = Meticillin resistant Staphylococcus aureus, NK= not known, PO = Oral, VRE = Vancomycin resistant Enterococcus

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