====== 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.)). ---- 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.)). ---- [[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: . ISSN 0250-3816)). ===== Prophylactic antibiotics for temporal bone fracture ===== [[Prophylactic antibiotics for temporal bone fracture]].