Adult
Open Skull Fracture including CSF leak post skull fracture
For cases where there is open skull fracture resulting from penetrating injury, treat for 3 days.
Preferred (including penicillin allergy non-severe)
cefalexin 1g po tds AND metronidazole 400mg po tds
Alternative
For penicillin allergy (severe)
moxifloxacin* 400mg po od
Moxifloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
*Ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
Fluoroquinolones, including moxifloxacin, are associated with disabling and potentially long-lasting or irreversible side effects. See Fluoroquinolone antibiotics - severe adverse effects.
CSF leak post skull fracture
No antibiotics indicated.
Administer Pneumovax®