Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 1994 Sep;5(5):210-5.
doi: 10.1155/1994/257198.

Dexamethasone therapy for bacterial meningitis: Better never than late?

S M King  1 , B Law, J M Langley, H Heurter, D Bremner, E E Wang, R Gold
Affiliations

Dexamethasone therapy for bacterial meningitis: Better never than late?

S M King et al. Can J Infect Dis. 1994 Sep.

Abstract
in English, French

A multicentre randomized controlled trial was conducted in children with bacterial meningitis using dexamethasone or placebo for four days within 24 h of starting antibiotics. Primary outcomes were hearing loss and neurological abnormalities at 12 months after meningitis. The dexamethasone (n=50) and placebo (n=51) groups were similar in age, severity of illness and etiological agent. Hearing loss occurred in 10% and 11% of the dexamethasone and placebo groups and neurological deficits occurred in 20% and 18% of patients, respectively. Duodenal perforation occurred in one dexamethasone-treated child. In conclusion, there was no significant benefit in those receiving dexamethasone. The lack of benefit may have been due to the delay in administration of dexamethasone (median delay of 11 h after antibiotics). Therefore, if dexamethasone is used for meningitis it should be given immediately with the antibiotic.

Un essai contrôlé, randomisé, multicentrique a été effectué auprès d’enfants atteints de méningite bactérienne et traités à l’aide de dexaméthasone ou de placebo durant quatre jours dans les 24 heures de l’amorce de l’antibiothérapie. Les principaux signes ont été la perte d’audition et certaines anomalies neurologiques douze mois après la méningite. Les groupes sous dexaméthasone (n=50) et placebo (n=51) étaient d’un âge similaire, présentaient une maladie d’une gravité équivalente due au même agent étiologique. Une perte d’audition est a été enregistrée chez 10 et 11 % des sujets du groupe dexaméthasone et placebo et les déficits neurologiques sont survenus chez 20 et 18 % des patients respectivement. Une perforation duodénale est survenue chez un enfant traité par dexaméthasone. Nous en avons conclu qu’il n’y a pas d’avantages significatifs à tirer de l’administration de dexaméthasone. L’absence d’effets favorables peut avoir été attributable au retard d’administration de la dexaméthasone (retard moyen de 11 heures après les antibiotiques). Par conséquent, si la dexaméthasone est utilisée dans la méningite, elle devrait être administrée immédiatement avec l’antibiotique.

Keywords: Bacterial meningitis; Dexamethasone; Pediatrics.

PubMed Disclaimer

References

    1. Wenger JD, Hightower AW, Facklam RR, Gaventa S, Broome CV, Bacterial Meningitis Study Group Bacterial meningitis in the United States, 1986: report of a multistate surveillance study. J Infect Dis. 1990;162:1316–23. - PubMed
    1. Scheld WF, III, Ward JI, Band JD, Hightower A, Fraser DW, Broome CV. Bacterial meningitis in the United States, 1978 through 1981. The national bacterial meningitis surveillance study. JAMA. 1985;253:1749–54. - PubMed
    1. Durand ML, Calderwood SB, Weber DJ, et al. Acute bacterial meningitis in adults: A review of 493 episodes. N Engl J Med. 1993;328:21–8. - PubMed
    1. Pomeroy SL, Holmes SJ, Dodge PR, Feigin RD. Seizures and other neurologic sequelae of bacterial meningitis in children. N Engl J Med. 1990;323:1651–7. - PubMed
    1. Taylor HG, Mills EL, Ciampi A, et al. The sequelae of Haemophilus influenzae meningitis in school-age children. N Engl J Med. 1990;323:1657–63. - PubMed

LinkOut - more resources