Once NBM is suspected, aggressive empirical antimicrobial therapy is indicated along with catheter removal.

According to New England Journal of Medicine recommendations, adoption of simple techniques before, during and after surgery can minimise the risk of postoperative meningitis. These include draping the surgical site with adhesive drapes to prevent implantable hardware from coming in contact with exposed skin, use of double layer of gloves when handling implantable devices, using percutaneous drains to collect postoperative haemorrhage after surgery etc.2 Evidence suggests that antibiotic-impregnated catheters reduce the incidence of shunt infection.

The avoidance of modifiable risk factors in the causation of NBM should be emphasised. These include the duration and frequency of catheterisation, intraventricular haemorrhage, and insertion techniques.