Dexamethasone therapy for bacterial meningitis in children: 2- versus 4-day regimen

J Infect Dis. 1994 Apr;169(4):853-8. doi: 10.1093/infdis/169.4.853.

Abstract

Four-day dexamethasone therapy has been used to treat bacterial meningitis. This prospective, randomized study compared the effect of a 2-day versus a 4-day regimen. Children (n = 118, ages 2.5 months to 15 years) were evaluated; 50% of the cases were due to Neisseria meningitidis and 40% to Haemophilus influenzae type b. Patients were treated intravenously (iv) mainly with conventional antimicrobial therapy and were randomly assigned to receive dexamethasone, 0.15 mg/kg iv every 6 h for 2 or 4 days. The clinical response was similar for both dexamethasone regimens. The meningococcal meningitis patients survived without neurologic or audiologic sequelae. On long-term follow-up, neurologic sequelae or moderate or more severe unilateral or bilateral hearing impairment (or both) were found in 1.8% and 3.8% of patients treated with dexamethasone for 2 and 4 days, respectively. The 2-day regimen appears appropriate for the treatment of H. influenzae and meningococcal meningitis.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Cerebrospinal Fluid / chemistry
  • Cerebrospinal Fluid / cytology
  • Cerebrospinal Fluid Proteins / analysis
  • Child
  • Child, Preschool
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / chemically induced
  • Glucose / cerebrospinal fluid
  • Hearing Loss / etiology
  • Humans
  • Infant
  • Leukocyte Count
  • Male
  • Meningitis, Haemophilus / complications
  • Meningitis, Haemophilus / drug therapy*
  • Meningitis, Meningococcal / complications
  • Meningitis, Meningococcal / drug therapy*
  • Meningitis, Pneumococcal / complications
  • Meningitis, Pneumococcal / drug therapy*
  • Nervous System Diseases / etiology
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Cerebrospinal Fluid Proteins
  • Dexamethasone
  • Glucose