Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis
Introduction: There are no randomized controlled trials to inform the choice of using adjunctive dexamethasone (AD) against Listeria monocytogenes meningitis (LMM) and data from observational studies are pretty conflicting. Methodology: We performed a rapid review of the literature with quantitat...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
The Journal of Infection in Developing Countries
2023-12-01
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| Series: | Journal of Infection in Developing Countries |
| Subjects: | |
| Online Access: | https://jidc.org/index.php/journal/article/view/18804 |
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| Summary: | Introduction: There are no randomized controlled trials to inform the choice of using adjunctive dexamethasone (AD) against Listeria monocytogenes meningitis (LMM) and data from observational studies are pretty conflicting.
Methodology: We performed a rapid review of the literature with quantitative analysis. A pairwise random-effects meta-analysis was implemented, pooling unadjusted and adjusted data. The main outcome was mortality.
Results: Across all included studies (five) informing the main analysis on raw mortality data, 199 patients received AD, as opposed to 382 who did not receive AD. All-cause mortality was slightly lower in patients undergoing AD, but not in a statistically significant manner: odds ratio 0.96, 95% confidence interval 0.42-2.19. The prediction interval was very wide (0.06-15.99), suggesting that in future studies the effect of AD might be either beneficial or harmful.
Conclusions: The role of AD for LMM still needs to be established being the current evidence inconclusive and heterogeneous.
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| ISSN: | 1972-2680 |