Controversies in neurology, Vienna, 2012: Steroids in bacterial meningitis: no

摘要: In acute bacterial meningitis long-term morbidity and mortality are still high, in particular, low middle income countries where meningococci the most frequent causative agents of this disease. If at all, dexamethasone has been shown to be helpful pneumococcal meningitis, i.e., elderly Europeans not adolescent African, Asian or South American patients. Since deranged glucose, glucose variability coagulation homeostasis known deleterious patients with dexamethasone—being capable cause both—might add mortality. After more than 20 prospective trials evidence lacks that improves outcome majority Dexamethasone only exerts a positive effect, if given prior first dose antibiotic; therefore, introduction empiric antimicrobial chemotherapy into emergency (= pre-hospital) management suspected discussion on is rendered almost futile.