Table 2.

Studies of Prophylactic Antibiotics in Basilar Skill Fractures with CSF Leak

Study	Study Quality	N	Antibiotic	Antibiotic Duration (days)	Rates of Meningitis	Comments
Ignelzi et al. 1975	moderate	10	Ampicillin or Cephalothin 1g IV q6H	10	OR 1.0 (no infections in either group)	Nasopharyngeal flora changed towards more invasive, resistant Gram negative species
Hoff et al. 1976	moderate	160	Treatment Group 1: Penicillin G 1.2M units IV daily Treatment Group 2: Penicillin G 20M IV units daily	3	OR 1.0 (no infections in the three groups)	None
Klastersky et al. 1976	high	52	Penicillin G 5M units IV Q6H	Not Specified; Median 7.0 days (range 4–21 days)	1/26 in placebo; 0/26 in treatment	3 patients in placebo group and one patient in the penicillin group were treated for suspected meningitis but had negative cultures
Demetriades et al. 1992	moderate	157	Treatment Group 1: Ceftriaxone 1g IV daily Treatment Group 2: Ampicillin/Sulphadiazine 1g/0.5g Q6H	3	2.1% in placebo / 0.0% in treatment	If including scalp wounds, rates of meningitis/SSI was 8.7% in placebo group and 0.9% in prophylaxis group
Eftekhar et al. 2004	moderate	109	Ceftriaxone 1gm IV daily	At least 5	21.5% in placebo / 18.9% in treatment	Overall high rate of meningitis; Inclusion criteria required pneumocephalus