Role of prophylactic antibiotics in open and basilar fractures of the skull: a randomized study

Injury. 1992;23(6):377-80. doi: 10.1016/0020-1383(92)90011-g.


The aim of this study was to investigate the controversial issue of the use of prophylactic antibiotics in open and basilar fractures of the skull. A series of 157 patients were randomized to receive no antibiotics (group A = 46 patients) or ceftriaxone for 3 days (group B = 50 patients), or the combination ampicillin/sulphadiazine for 3 days (group C = 61 patients). The incidence of meningitis was similar in both the antibiotic and non-antibiotic groups. However, the overall incidence of infectious complications in the non-antibiotic group was significantly higher than in the antibiotic group (8.7 per cent vs 0.9 per cent, P < 0.05). There was no significant difference between the ceftriaxone group and the ampicillin/sulphadiazine group. The results of the study suggest that antibiotic prophylaxis has a role in the management of open and basilar fractures.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / prevention & control*
  • Ceftriaxone / therapeutic use
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Fractures, Open / complications*
  • Humans
  • Male
  • Meningitis / prevention & control
  • Occipital Bone / injuries*
  • Skull Fractures / complications*
  • Sulfadiazine / therapeutic use
  • Time Factors


  • Anti-Bacterial Agents
  • Sulfadiazine
  • Ceftriaxone
  • Ampicillin