[Corticosteroid treatment in bacterial meningitis of adults and children].
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.
Thomas
Rémi
R
Service de maladies infectieuses et réanimation médicale, CHU Rennes, hôpital Pontchaillou, 35033 Rennes Cedex. remi.thomas@chu-rennes.fr
D000328:Adult; D002648:Child; D017714:Community-Acquired Infections / Q000188:drug therapy; D003907:Dexamethasone / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D016920:Meningitis, Bacterial / Q000188:drug therapy*
D005938:Glucocorticoids; D003907:Dexamethasone