Dexamethasone and prognostic factors in adults with bacterial meningitis.
OBJECTIVE
To determine the effect of dexamethasone on prognostic factors in adults with bacterial meningitis.


METHODS
A post hoc multivariate analysis of the European Dexamethasone Study.


METHODS
Dexamethasone-treated patients in the European Dexamethasone Study. As internal validation we performed an identical analysis on patients in the placebo group.


RESULTS
Only focal cerebral abnormalities on admission were predictive for unfavourable outcome in patients treated with early adjunctive dexamethasone (Odds ratio 3.22; 95% confidence interval 1.11-9.35; P=0.03). Other potential prognostic factors failed to achieve statistical significance. An analysis on patients in the placebo group showed prognostic factors comparable with those found in the literature without routine use of dexamethasone.


CONCLUSIONS
Routine use of dexamethasone therapy may lead towards new risk stratification in adults with bacterial meningitis.
Weisfelt
Martijn
M
Department of Neurology, Academic Medical Center, 22660, 1100 DD, Amsterdam, The Netherlands. M.weisfelt@amc.uva.nl
van de Beek
Diederik
D
de Haan
Rob J
RJ
de Gans
Jan
J
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D016001:Confidence Intervals; D003907:Dexamethasone / Q000627:therapeutic use*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone