title: Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks.
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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology,Royal National Throat, Nose and Ear Hospital,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Rimmer
authors.affiliation: Department of Otolaryngology,Royal National Throat, Nose and Ear Hospital,London,UK.
authors.forename: C
authors.initials: C
authors.lastname: Belk
authors.affiliation: Department of Otolaryngology,Royal National Throat, Nose and Ear Hospital,London,UK.
authors.forename: V J
authors.initials: VJ
authors.lastname: Lund
authors.affiliation: Department of Otolaryngology,Aintree University Hospital NHS Foundation Trust,Liverpool,UK.
authors.forename: A
authors.initials: A
authors.lastname: Swift
authors.affiliation: Department of Otolaryngology,Ninewells Hospital,Dundee,Scotland,UK.
authors.forename: P
authors.initials: P
authors.lastname: White
mesh_terms: D000900:Anti-Bacterial Agents; D019072:Antibiotic Prophylaxis / Q000379:methods*; D065634:Cerebrospinal Fluid Leak / Q000150:complications / Q000628:therapy*; D006801:Humans; D007114:Immunization / Q000379:methods*; D016920:Meningitis, Bacterial / Q000209:etiology / Q000517:prevention & control*; D011379:Prognosis; D019291:Skull Base; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents