Prophylactic administration of ceftriaxone for the prevention of meningitis after traumatic pneumocephalus: results of a clinical trial
- 1 November 2004
- journal article
- clinical trial
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery
- Vol. 101 (5), 757-761
- https://doi.org/10.3171/jns.2004.101.5.0757
Abstract
Object. The purpose of this study was to compare the efficacy of the prophylactic use of ceftriaxone for the prevention of meningitis in patients with acute traumatic pneumocephalus. Methods. In this prospective, single-institution, randomized clinical trial, 109 patients with mild head injury and traumatic pneumocephalus were randomly assigned to receive or not receive an antibiotic medication (ceftriaxone, 1 g given twice a day) until occurrence of meningitis or at least 5 days after trauma. The patients were followed up for 1 month posttrauma. The 109 patients were divided into two groups: 53 were assigned to the prophylactic antibiotics therapy group and 56 to the control group. The overall rate of meningitis was 20.1% and the rates of meningitis in the two groups were not significantly different. The results were the same when adjusted for the patient's Glasgow Coma Scale score, sex, and age, as well as for an intradural location of air, air volume, presence of cerebrospinal fluid (CSF) rhinorrhea or CSF otorrhea, radiological sign of a skull base fracture, or intracranial hemorrhage. Conclusions. The results of this study do not substantiate the efficacy of ceftriaxone used in the prevention of meningitis in patients with traumatic pneumocephalus after mild head injury or in any specific subgroup of these patients. Cerebrospinal fluid rhinorrhea and intracranial hemorrhage may be considered primary risk factors for the development of meningitis in patients with posttraumatic pneumocephalus and, in the absence of these symptoms, intradural location of air and air volume greater than 10 ml may be considered secondary risk factors. Further studies in this area are warranted.5 page(sKeywords
This publication has 23 references indexed in Scilit:
- The ABCs of Measuring Intracerebral Hemorrhage VolumesStroke, 1996
- Infectious Complications in Patients with Severe Head InjuryThe Journal of Trauma and Acute Care Surgery, 1988
- Prognosis, incidence and management of acute traumatic intracranial pneumocephalusActa Neurochirurgica, 1986
- Analysis of the treatment of basilar skull fractures with and without antibioticsJournal of Neurosurgery, 1975
- CONSERVATIVE AND OPERATIVE MANAGEMENT FOR CEREBROSPINAL-FLUID LEAKAGE AFTER CLOSED HEAD INJURYThe Lancet, 1973
- Traumatic cerebrospinal fluid fistulas in childrenJournal of Neurosurgery, 1973
- Traumatic Cranionasal Fistulas Persistent Cerebrospinal Fluid Rhinorrhoea and their Repair with Frontal Sinus OsteoplastyActa Oto-Laryngologica, 1970
- POSTTRAUMATIC CEREBROSPINAL FLUID FISTULA OF THE FRONTAL FOSSAThe Journal of Trauma and Acute Care Surgery, 1966