Dexamethasone therapy for bacterial meningitis in children: 2- versus 4-day regimen.
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.
Syrogiannopoulos
G A
GA
Department of Pediatrics, University of Patras, Medical School, Greece.
Lourida
A N
AN
Theodoridou
M C
MC
Pappas
I G
IG
Babilis
G C
GC
Economidis
J J
JJ
Zoumboulakis
D J
DJ
Beratis
N G
NG
Matsaniotis
N S
NS
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000166:cytology; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D005947:Glucose / Q000134:cerebrospinal fluid; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D008583:Meningitis, Haemophilus / Q000150:complications / Q000188:drug therapy*; D008585:Meningitis, Meningococcal / Q000150:complications / Q000188:drug therapy*; D008586:Meningitis, Pneumococcal / Q000150:complications / Q000188:drug therapy*; D009422:Nervous System Diseases / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002556:Cerebrospinal Fluid Proteins; D003907:Dexamethasone; D005947:Glucose