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: Alberto Enrico Maraolo, Maria Mazzitelli
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2023-12-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/18804
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author Alberto Enrico Maraolo
Maria Mazzitelli
author_facet Alberto Enrico Maraolo
Maria Mazzitelli
author_sort Alberto Enrico Maraolo
collection DOAJ
description 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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spelling doaj-art-b58e206618a044d69258e3436e514ce12025-08-20T02:14:20ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-12-01171210.3855/jidc.18804Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitisAlberto Enrico Maraolo0Maria Mazzitelli1First Division of Infectious Diseases, Cotugno Hospital, Naples, ItalyDepartment of Molecular Medicine, Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy 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. https://jidc.org/index.php/journal/article/view/18804dexamethasonemeta-analysisneurolisteriosistherapysteroidsystematic review
spellingShingle Alberto Enrico Maraolo
Maria Mazzitelli
Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis
Journal of Infection in Developing Countries
dexamethasone
meta-analysis
neurolisteriosis
therapy
steroid
systematic review
title Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis
title_full Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis
title_fullStr Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis
title_full_unstemmed Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis
title_short Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis
title_sort predisposing factor impactful adjunctive treatment or unfavorable prognostic marker a meta analysis on the elusive role of dexamethasone for listeria monocytogenes meningitis
topic dexamethasone
meta-analysis
neurolisteriosis
therapy
steroid
systematic review
url https://jidc.org/index.php/journal/article/view/18804
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