Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae

A meta-analysis

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Objective: To determine the efficacy of prophylactic antibiotics in the treatment of posttraumatic cerebrospinal fluid fistulae. Design: Meta- analysis with literature review. Methods: 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 meningitis were included in the analysis. Results: 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). Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)749-752
Number of pages4
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume123
Issue number7
StatePublished - Jul 1997

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Fistula
Cerebrospinal Fluid
Meta-Analysis
Meningitis
Anti-Bacterial Agents
Incidence
MEDLINE
Therapeutics

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

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title = "Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae: A meta-analysis",
abstract = "Objective: To determine the efficacy of prophylactic antibiotics in the treatment of posttraumatic cerebrospinal fluid fistulae. Design: Meta- analysis with literature review. Methods: 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 meningitis were included in the analysis. Results: 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). Conclusions: 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.",
author = "Brodie, {Hilary A}",
year = "1997",
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language = "English (US)",
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journal = "JAMA Otolaryngology - Head and Neck Surgery",
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T1 - Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae

T2 - A meta-analysis

AU - Brodie, Hilary A

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N2 - Objective: To determine the efficacy of prophylactic antibiotics in the treatment of posttraumatic cerebrospinal fluid fistulae. Design: Meta- analysis with literature review. Methods: 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 meningitis were included in the analysis. Results: 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). Conclusions: 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.

AB - Objective: To determine the efficacy of prophylactic antibiotics in the treatment of posttraumatic cerebrospinal fluid fistulae. Design: Meta- analysis with literature review. Methods: 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 meningitis were included in the analysis. Results: 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). Conclusions: 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.

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