Role of adjunctive dexamethasone therapy in bacterial meningitis
What is the role of adjunctive dexamethasone therapy in patients with bacterial meningitis?
Dexamethasone has been shown to improve functional outcome and reduce mortality in patients with acute community-acquired bacterial meningitis.
Administration of dexamethasone (0.15 mg/kg q6h for 2 to 4 days with the first dose administered 30 minutes before, or at least concomitantly with, the first dose of antimicrobial therapy) in adults with suspected or proven pneumococcal meningitis has been recommended.
Dexamethasone should only be continued if either the CSF Gram stain reveals gram-positive diplococci or if blood or CSF cultures are positive for Streptococcus pneumoniae .
Adjunctive dexamethasone should not be given to adult patients who have already received antimicrobial therapy because administration of dexamethasone in this circumstance is unlikely to improve patient outcome.
