Corticosteroids and Mortality in Children With Bacterial Meningitis

Abstract

Adjuvant corticosteroid therapy reduces hearing loss in children with meningitis caused by Haemophilus influenzae type b (Hib). However, the epidemiology of bacterial meningitis has changed dramatically following the licensure and widespread use of vaccines against Hib in 1985 and Streptococcus pneumoniae in 2000. The current benefit of adjuvant corticosteroids for the treatment of bacterial meningitis in children remains unclear. Guidelines from the Committee on Infectious Disease of the American Academy of Pediatrics acknowledge this uncertainty and state that for infants and children aged 6 weeks or older, “adjunctive therapy with dexamethasone may be considered after weighing the potential benefits and risks.”¹ Adjuvant corticosteroids, when used, should be administered with or shortly before the first dose of antimicrobial therapy.¹