REVIEW
Introdução: Meningite é uma inflamação das membranas meníngeas frequentemente causada por agentes infecciosos, pode estar associada ao traumatismo cranioencefálico (TCE). Fraturas da base do crânio (FBC) e fístulas liquóricas (FLCR) decorrentes do TCE aumentam o risco de meningite pós traumática (MPT). Este estudo analisa evidências sobre o uso de antibióticos na prevenção da MPT. Metodologia: Revisão sistemática baseada na pergunta: “Antibiótico após TCE para prevenir meningite: usar ou não?”. Consulta às bases de dados PubMed, Scielo e BVS com descritores relevantes. Seleção de 15 artigos publicados nos últimos 10 anos, sem restrições de idioma ou nacionalidade. Resultados: Foram identificados fatores de risco para MPT. Alguns estudos não apoiam o uso profilático de antibióticos em pacientes com FBC. Resultados variáveis foram observados em estudos longitudinais e de coorte. Conclusão: Ainda que o presente estudo forneça evidências sobre a influência negativa dos antibióticos, o manejo profilático da MPT apresenta limitações que necessitam de uma análise criteriosa.
Introduction: Meningitis, an inflammation of the meningeal membranes often caused by infectious agents, can be associated with traumatic brain injury (TBI). Basilar skull fractures (BSF) and cerebrospinal fluid (CSF) fistulas resulting from TBI increase the risk of developing the disease. Despite a lower reported incidence of CSF leaks, the risk of meningitis persists, thus prompting research into the efficacy of antibiotic prophylaxis. This study assesses the use of antibiotics in preventing post-traumatic meningitis. Methodology: A systematic review based on the question: “Antibiotics post-TBI to prevent meningitis: to use it or not?” conducted in PubMed, Scielo, and BVS databases using relevant descriptors. We selected 14 articles published in the last 10 years, with no language or nationality restrictions. Results: Risk factors for post-traumatic meningitis were identified. Some studies do not support the prophylactic use of antibiotics in patients with BSF. Variable outcomes were observed in longitudinal and cohort studies. Conclusion: Although this study provides evidence of the negative influence of antibiotics, the prophylactic management of post-traumatic meningitis presents limitations that require careful analysis.
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1Department of Neurosurgery, Centro Universitário Atenas, Passos, MG, Brazil.
2Department of Medicine, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
3Division of Neurosurgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, FMUSP, São Paulo SP, Brazil.
Received June 28, 2024
Accepted Aug 2, 2024