A Cochrane review «Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures»1 «Ratilal BO, Costa J, Pappamikail L et al. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Cochrane Database Syst Rev 2015;4():CD004884. »1 included 5 RCTs and 17 non-RCTs comparing different types of antibiotic prophylaxis with placebo or no intervention in patients with basilar skull fractures. Four RCTs (n=208) were included in a meta-analysis. All studies included meningitis in their primary outcome. When the RCTs were evaluated, there were no significant differences between antibiotic prophylaxis groups and control groups in terms of reduction of the frequency of meningitis, all-cause mortality, meningitis-related mortality and need for surgical correction in patients with CSF leakage. There were no reported adverse effects of antibiotic administration, although one of the five RCTs reported an induced change in the posterior nasopharyngeal flora towards potentially more pathogenic organisms resistant to the antibiotic regimen used in prophylaxis. A meta-analysis of all the controlled non-RCTs (n=2168) produced results consistent with the randomised data from the included studies.