What is the risk of meningitis, utilising a single agent, single dose peri-operative antibiotic following endonasal endoscopic repair of a CSF leak?.

Nix, P.

What is the risk of meningitis, utilising a single agent, single dose peri-operative antibiotic following endonasal endoscopic repair of a CSF leak?.

All Authors

Nix, P.

LTHT Author

Nix, Paul

LTHT Department

Ear, Nose & Throat

Publication Date

2025

Item Type

Journal Article

Abstract

OBJECTIVES: Endoscopic endonasal surgery of the skull base carries the risk of meningitis. However, no consensus on the prophylactic antibiotic regimen exists. METHODS: A prospectively held database documenting endoscopic endonasal repair of cerebrospinal fluid (CSF) leaks in the anterior skull base was reviewed. Post-operative meningitis and antibiotic usage within 30 days of the index procedure were recorded. RESULTS: A total of 285 consecutive cases were identified with a post-operative meningitis rate of 3.5 per cent. The post-operative confirmed bacterial meningitis rate was 2 per cent. All cases received a single dose of a single agent antibiotic peri-operatively. The risk of developing post-operative meningitis was associated with a post-operative CSF leak in cases undergoing tumour resection of the anterior skull base. CONCLUSION: A single dose, single agent peri-operative antibiotic regimen would appear to be adequate following an endoscopic endonasal approach to repair a CSF leak in the anterior skull base.