Lambert 1984.

Methods	Randomised, controlled Method of randomisation: drawing a card Kind of shunt: ventriculoperitoneal and ventriculoatrial shunts Location: Germany Follow‐up: 6 months Duration: 21 months
Participants	Inclusion: any patient undergoing insertion or revision of a CSF shunt Exclusion: organisms resistant to gentamicin on surface swabs or recent surgery for CSF of shunt infection, antibiotics at time of surgery, revision of a colonized shunt system Treatment: 24; control: 20
Interventions	Gentamicin IV/intramuscular (3 mg/kg) and gentamicin intrathecal 5 mg above the level of the revision either into the ventricle or the shunt system versus povidone iodine and a control group
Outcomes	Proportion of participants who had shunt infection after new insertion or revision surgery No timing of outcome measurement described
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"Patients were allocated to one of three groups by drawing a card"
Allocation concealment (selection bias)	Unclear risk	Not described
Blinding of participants and personnel (performance bias) All outcomes	High risk	Povidone iodine and antibiotic can be distinguished
Blinding of outcome assessment (detection bias) All outcomes	High risk	Povidone iodine and antibiotic can be distinguished
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Exclusions not described
Selective reporting (reporting bias)	High risk	Study protocol not available and no pre‐specified outcome measures or analysis
Other bias	High risk	The dose of gentamicin was increased to 10 mg when ventricles were dilated. No cut‐off point for dilatation was described. No documentation about the number of participants with dilatated ventricles could be found