Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistula [Neurosurgery Wiki]

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====== Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistula ======

The rate of [[central nervous system infection]] (CNSI) is marginal and antibiotics do not appear to confer a protective advantage. A larger trial is needed to elucidate the true effect of antibiotics on preventing CNSIs in patients with [[posttraumatic pneumocephalus]] or [[cerebrospinal fluid leak]]
((Wang HP, Reif RJ, Kalkwarf KJ, Jensen HK, Jenkins AK, Bhavaraju A. Prophylactic Antibiotics in Patients with Traumatic Pneumocephalus or Cerebrospinal Fluid Leak. Am Surg. 2022 Aug 18:31348221117041. doi: 10.1177/00031348221117041. Epub ahead of print. PMID: 35979960.)).
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In a [[meta-analysis]] individually, each of the studies included in an analysis demonstrated no significant difference in the incidence of meningitis with [[prophylactic antibiotics]]. The reason for this is that inadequate numbers of patients were available at each institution. Pooling the data from the past 25 years revealed a statistically significant reduction in the incidence of meningitis with prophylactic antibiotic therapy
((Brodie HA. [[Prophylactic antibiotics]] for posttraumatic cerebrospinal fluid fistulae. A meta-analysis. Arch Otolaryngol Head Neck Surg. 1997 Jul;123(7):749-52. doi: 10.1001/archotol.1997.01900070093016. PMID: 9236597.)).
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[[Prophylactic antibiotics]] is an [[option]] and not a [[recommendation]]
((JAUME, Alejandra et al. Fístula de líquido cefalorraquídeo postraumática: propuesta de algoritmo diagnóstico y terapéutico. Arch. Med Int [online]. 2015, vol.37, n. 1 [citado  2022-08-24], pp.47-52. Disponível em: <http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-423X2015000100009&lng=pt&nrm=iso>. ISSN 0250-3816)).
===== Prophylactic antibiotics for temporal bone fracture =====

[[Prophylactic antibiotics for temporal bone fracture]].