Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures

Background: Patients with basilar skull fractures are at risk for developing meningitis. To decrease the risk of developing meningitis patients are often given prophylactic antibiotics. However its use has been controversial. This study aimed to study the effectiveness of prophylactic antibiotics to prevent meningitis in patients with a basilar skull fracture.

Primary outcome studied: Frequency of meningitis: suspected clinically (via symptoms) and confirmed by lumbar puncture

Secondary outcomes studied: All-cause mortality/meningitis-related mortality.
Need for surgical correction in patients with CSF leakage.
non-CNS infection.

This meta-analysis looked at five RCTS with a total of 208 patients with basilar skull fractured comparing patients given prophylactic antibiotics versus no prophylaxis, to see its effectiveness in preventing the development of meningitis.

There was no significant difference between the group receiving antibiotics versus the group receiving placebo or no antibiotics.

With the current data in this article the use of prophylactic antibiotics for patients with basilar skull fractures in not recommended.

Limitations: small sample size

Why I chose this article? Directly relates to one of the cases I presented on my site visit.