Bactericidal External ventricular drainS in paTients with Traumatic Brain Injury

External ventricular drain (EVD) catheters are integral to the management of patients with severe traumatic brain injury (TBI). EVDs are routinely used in the management of severe TBI, and are recommended by international consensus guidelines. These catheters monitor and can help to lower the pressure within the brain that is often raised as a result of the brain injury. This process is not without risks. The EVD catheter provides a pathway between the brain and the external environment, which can become colonised by bacteria and lead to infection in the brain, called 'meningitis' or 'ventriculitis'. This infection may worsen brain damage, produce seizures, and increase length of stay in the hospital. One potential way of reducing this risk of EVD-associated infection is to use antibiotic-impregnated catheters. These EVDs release antibiotics over time, with the aim of preventing bacteria from contaminating the drains. Despite previous research it is still unclear if there is benefit to using these drains, which are considerably more expensive than the standard EVDs. The aim of this project is to determine if antibiotic-impregnated EVDs reduce the rates of infection in patients with TBI. In this study, patients with TBI who are planned for EVD insertion will have a 50:50 chance (like flipping a coin) to receive either a standard or antibiotic-impregnated EVD. After insertion, patients will be monitored until the EVD is removed (generally within 10 days following injury) to see if they develop catheter-associated infection. Results will then be compared to see if there is a difference between each group.