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Arch Otolaryngol Head Neck Surg. 1997 Jul;123(7):749-52.
Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae. A meta-analysis.
Brodie HA.
Abstract
To determine the efficacy of prophylactic antibiotics in the treatment of posttraumatic cerebrospinal fluid
fistulae.
Meta-analysis with literature review.
A MEDLINE search was performed to obtain all the reports pertaining to posttraumatic cerebrospinal fluid
fistulae between 1970 and 1995. All the series that provided data specifying whether prophylactic antibiotics were
provided and the incidence of the meningitis were included in the analysis.
The findings of 6 studies, involving 324 patients, were analyzed. In these studies, 237 received
prophylactic antibiotics and 87 did not. Only 6 of the 237 patients who received prophylactic antibiotics developed
meningitis, yielding an incidence of 2.5%. Nine (10%) of the 87 patients who did not receive prophylactic antibiotics
developed meningitis. The incidence of meningitis was significantly lower in the patients who received prophylactic
antibiotics than in those who did not receive prophylaxis (Fisher exact test, P = .006).
Individually, each of the studies included in this analysis demonstrated no significant difference in
the incidence of meningitis with prophylactic antibiotic therapy. 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.
PMID: 9236597 [PubMed - indexed for MEDLINE]
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