Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?

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) an...

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Main Authors: Susan M King, Barbara Law, Joanne M Langley, Helen Heurter, Diane Bremner, Elaine E Wang, Ronald Gold
Format: Article
Language:English
Published: Wiley 1994-01-01
Series:Canadian Journal of Infectious Diseases
Online Access:http://dx.doi.org/10.1155/1994/257198
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author Susan M King
Barbara Law
Joanne M Langley
Helen Heurter
Diane Bremner
Elaine E Wang
Ronald Gold
author_facet Susan M King
Barbara Law
Joanne M Langley
Helen Heurter
Diane Bremner
Elaine E Wang
Ronald Gold
author_sort Susan M King
collection DOAJ
description 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.
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series Canadian Journal of Infectious Diseases
spelling doaj-art-09f42a2255fb4c06bd6ea80d05710edb2025-08-20T02:03:16ZengWileyCanadian Journal of Infectious Diseases1180-23321994-01-015521021510.1155/1994/257198Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?Susan M King0Barbara Law1Joanne M Langley2Helen Heurter3Diane Bremner4Elaine E Wang5Ronald Gold6Division of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, CanadaDivision of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, CanadaDivision of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, CanadaDivision of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, CanadaDivision of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, CanadaDivision of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, CanadaDivision of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, CanadaA 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.http://dx.doi.org/10.1155/1994/257198
spellingShingle Susan M King
Barbara Law
Joanne M Langley
Helen Heurter
Diane Bremner
Elaine E Wang
Ronald Gold
Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?
Canadian Journal of Infectious Diseases
title Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?
title_full Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?
title_fullStr Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?
title_full_unstemmed Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?
title_short Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?
title_sort dexamethasone therapy for bacterial meningitis better never than late
url http://dx.doi.org/10.1155/1994/257198
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AT helenheurter dexamethasonetherapyforbacterialmeningitisbetterneverthanlate
AT dianebremner dexamethasonetherapyforbacterialmeningitisbetterneverthanlate
AT elaineewang dexamethasonetherapyforbacterialmeningitisbetterneverthanlate
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