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Patients with survivable injuries face a risk of infection stemming from foreign body transgression into the central nervous system (CNS). There is controversy regarding the utility of antimicrobial prophylaxis in managing such patients, and if so, which antimicrobial agent(s) to use.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We reviewed patients with pTBI at our institution and performed a PRISMA systematic review to assess the impact of prophylactic antibiotics on reducing risk of CNS infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We identified 21 local patients and 327 cases in the literature. In our local series, 17 local\u00a0patients received prophylactic antibiotics; four did not. Overall, five of these\u00a0patients (24%) developed a CNS infection (four and one case of intraparenchymal brain abscess and meningitis, respectively). All four patients who did not receive prophylactic antibiotics developed an infection (three with CNS infections; one superficial wound infection) compared to two of 17 (12%) patients who did receive prophylactic antibiotics. Of the 327 pTBI cases reported in the literature, 216 (66%) received prophylactic antibiotics. Thirty-eight (17%) patients who received antibiotics developed a CNS infection compared to 21 (19%) who did not receive antibiotics (<jats:italic>p<\/jats:italic>\u2009=\u20090.76).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Although our review of the literature did not reveal any benefit, our institutional series suggested that patients with pTBI may benefit from prophylactic antibiotics. We propose a short antibiotic course with a regimen specific to cases with and without the presence of organic debris.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-022-05432-2","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T03:09:44Z","timestamp":1671419384000},"page":"303-313","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Antibiotic prophylaxis in penetrating traumatic brain injury: analysis of a single-center series and systematic review of the literature"],"prefix":"10.1007","volume":"165","author":[{"given":"Arjun","family":"Ganga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen P.","family":"Leary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul A.","family":"Sastry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael F.","family":"Asaad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantina A.","family":"Svokos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adetokunbo A.","family":"Oyelese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8898-7406","authenticated-orcid":false,"given":"Leonard A.","family":"Mermel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"issue":"2","key":"5432_CR1","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/S0090-3019(03)00158-7","volume":"60","author":"W Ardill","year":"2003","unstructured":"Ardill W, Gidado S (2003) Penetrating head wound: a remarkable case. 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