CORTICOSTEROIDS IN BACTERIAL MENINGITIS: WHAT'S NEW, WHAT'S TRUE?/Reply to Letter to the Editor: CORTICOSTEROIDS IN BACTERIAL MENINGITIS

[...] the authors recognize that treatment with dexamethasone signifi cantly reduced the risks of both unfavourable outcome and death in a European prospective randomized trial on 301 adult patients published in 2002 (2), but they outline that these data were not confi rmed in more recent studies (3...

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Bibliographic Details
Published in:Acta clinica belgica (English ed. Online) 2011-11, Vol.66 (6), p.455
Main Authors: Frippiat, F, Moutschen, M, Spapen, H, Van Berlaer, G, Moens, M, Hubloue, I
Format: Article
Language:English
Subjects:
Clinical trials
Meningitis
Mortality
Streptococcus infections
Online Access:Get full text
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Summary:[...] the authors recognize that treatment with dexamethasone signifi cantly reduced the risks of both unfavourable outcome and death in a European prospective randomized trial on 301 adult patients published in 2002 (2), but they outline that these data were not confi rmed in more recent studies (3-6). [...] Spapen et al. state that the decreased mortality reported in the initial study published in 2002 could be explained by a reduction in systemic (septic shock and acute lung injury) rather than neurological complications, following a post-hoc analysis of the European study in patients with pneumococcal meningitis (13). [...] de Gans et al had already expressed concerns in this regard and noticed that therapeutic failures had been described in adults treated with standard doses of vancomycin and adjunctive steroids advising that "patients with pneumococcal meningitis who are treated with vancomycin and steroids should be carefully monitored throughout therapy " (2, 7).
ISSN:1784-3286
2295-3337