Evaluation of efficacy of prophylactic antibiotic therapy in prevention of incidence of meningitis in patient with basilar skull fracture and cerebrospinal fluid leakage in traumatic patient reffer to golestan hospital of ahvaz in 2014-2015

Patients with traumatic base skull fractures with cerebrospinal fluid leakage were selected. All participants underwent CT scans upon arrival. Patients with visible lesions on CT scans in need of surgery for example Depress skull fracture, space occupying lesions, signs of intracranial pressure increase excluded. At least 350 patient selected. Then placebo drugs with complete resemblance to cotrimoxazole and amoxicillin provided. These drugs were placed in two boxes, box A and box B, and offered to patients as ordered by the physician. All patients received standard conservative treatment and lumber punctures were performed during the first three days of admission. All patients with cerebrospinal fluid disturbance and meningitis were excluded from the study. Patients were divided into two groups. In the treatment group, patients were given prophylactic antibiotics along with oral cotrimoxazole and amoxicillin. In the control group, patients received standard conservative treatment along with placebo drugs.In cases with cerebrospinal fluid leakage for over 3 days, a lumber puncture was repeated or lumber drain was placed. In cases with signs of meningitis such as fever, purulent discharge, meningismus excluded from study. Another lumbar puncture was performed after ceasing of cerebrospinal fluid leakage and before discharge in the other patients. Patients were examined for headaches and signs of meningitis in their first follow up visit after release. Finally, evaluate efficacy of prophylactic antibiotic in prevention of morbidity and mortality of meningitis.

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