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Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks

Published online by Cambridge University Press:  14 July 2014

J Rimmer ,
C Belk ,
V J Lund ,
A Swift  and
P White
J Rimmer*
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, London, UK
C Belk
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, London, UK
V J Lund
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, London, UK Ear Institute, University College London, UK
A Swift
Affiliation:
Department of Otolaryngology, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
P White
Affiliation:
Department of Otolaryngology, Ninewells Hospital, Dundee, Scotland, UK
*
Address for correspondence: Ms Joanne Rimmer, Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, London WC1X 8DA, UK Fax: 020 7883 9480 E-mail: rimmer.joanne@gmail.com
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Abstract

Objective:

There are no UK guidelines for the use of antibiotics and/or immunisations in patients with an active anterior skull base cerebrospinal fluid leak. This study aimed to define current UK practice in this area and inform appropriate guidelines for ENT surgeons.

Method:

A web-based survey of all members of the British Rhinological Society was carried out and the literature in this area was reviewed.

Results:

Of those who responded to the survey, 14 per cent routinely give prophylactic antibiotics to patients with cerebrospinal fluid leaks, and 34.9 per cent recommend immunisation against at least one organism, most commonly Streptococcus pneumoniae (86.7 per cent).

Conclusion:

There is no evidence to support the use of antibiotic prophylaxis in patients with a cerebrospinal fluid leak. We propose that all such patients are advised to seek immunisation against pneumococcus, meningococcus and haemophilus.

Keywords

Cerebrospinal Fluid RhinorrheaSkull BaseMeningitisVaccinationAntibiotic Prophylaxis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 7 , July 2014 , pp. 626 - 629
Copyright
Copyright © JLO (1984) Limited 2014 

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