Corticosteroid treatment in bacterial meningitis of adults and children
Thomas, R.ém.
La Revue du Praticien 54(9): 968-972
2004
ISSN/ISBN: 0035-2640 PMID: 15296274 Document Number: 575889
The neurologic deleterious effect of bacterial meningitis are the consequences of an inflammatory local response suggesting that an adjunctive anti-inflammatory therapy is able to favoured a better prognostic. Many clinical trials indicate that dexamethasone significantly reduce auditive sequella in children with meningitis due to Haemophilus influenzae, reduce mortality and morbidity of meningitis due to S. pneumoniae in adults but has few effect on Neisseria meningitidis. Corticotherapy should be initiated just before or at the time of first antibiotherapy and prolonged during 2 to 4 days. Major concern is a potential decrease of antibiotics concentration in cerebrospinal fluid that may be detrimental in patients with meningitis caused by S. pneumoniae strains that are highly resistant to penicillin or cephalosporins.