Meningitis: Corticosteroids for acute bacterial meningitis
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2002 Nov 14;347(20):1549-56 Randomized Controlled Trial, Multicenter Study
IN meningitis, acute, bacterial The Use of
systemic corticosteroids, dexametasona (10 mg/6h IV x 4 days)
As Treatment, Acute
Is better Than
placebo
To reduce combined outcome "mortality and neurological damage" at 8 weeks, specially if pneumococcal etiology. Not quantified in the abstract.
Lancet Neurol. 2010 Mar;9(3):254-63 Meta-Analysis
IN meningitis, acute, bacterial The Use of
systemic corticosteroids, dexamethasone
As Treatment, Acute
Is equal Than
placebo
To reduce mortality (26.5% dexamet VS 27.2% placebo) or severe neurological sequellae (42.3%dexamet VS 44.3% placebo). However, dexamethasone reduced hearing loss in survivors (24%vs 29.5%)
N Engl J Med. 2007 Dec 13;357(24):2431-40 Randomized Controlled Trial
IN meningitis, acute, bacterial The Use of
systemic corticosteroids, dexamethasone
As Treatment, Acute
Is equal Than
placebo
To to reduce, at 6 months, mortality and disability in all patients. In patients with confirmed bacterial meningitis there were a reduction at 6 months in mortality (RR 0.43)
N Engl J Med. 2007 Dec 13;357(24):2441-50 Randomized Controlled Trial
IN meningitis, acute, bacterial The Use of
systemic corticosteroids, dexamethasone (16 mg twice daily for 4 days)
As Treatment, Acute
Is equal Than
placebo
To reduce at 40 days mortality ordisability, either in all patients or in patients with proven pneumococcal meningitis.