Dexamethasone for adult bacterial meningitis

Abstract

Introduction: Mortality and morbidity from adult community-acquired bacterial meningitis remain quite high despite the use of appropriate antibiotics [1]. Experimental studies in animals have demonstrated that bacterial lysis–induced inflammation contributes to the poor outcome and that adjunctive treatment with dexamethasone reduces inflammation and sequelae [2]. In children, adjunctive dexamethasone therapy given before or with antibiotics has a beneficial effect on severe hearing loss caused by Haemophilus influenzae type 6 meningitis and may have a protective effect in those with pneumococcal meningitis [3]. In addition, adjunctive dexamethasone therapy has been shown to be beneficial for the outcome of adults with tuberculous (TB) meningitis [4]. Prior to the present study that is reviewed here, the paucity of data precluded a recommendation for the routine use of adjunctive dexamethasone therapy in adult bacterial meningitis.