A. Macaluso et al., DEXAMETHASONE ADJUNCTIVE THERAPY FOR BACTERIAL-MENINGITIS IN CHILDREN- A RETROSPECTIVE STUDY IN BRAZIL, Annals of tropical paediatrics, 16(3), 1996, pp. 193-198
The clinical records of 87 children with bacterial meningitis treated
with antibiotics (group I) and of 92 treated with antibiotics plus dex
amethasone (group 2), admitted to the Institute Materno Infantil de Pe
rnambuco, Recife, Brazil over 2 consecutive years (1991 and 1992), wer
e analysed. There were no significant differences between treatment gr
oups regarding characteristics on admission except that group 1 were y
ounger. The overall case fatality rate was 19%, with 14% in group 2 an
d 24% in group 1 (p = 0.09). Rate of discharge without sequelae was 70
% in the steroid-treated children and 56% in children treated with ant
ibiotics alone (p = 0.07). Among children aged 6-59 months, those trea
ted with dexamethasone compared with those treated with antibiotics al
one had a better case fatality rate (11% vs 25%; p = 0.05) and a bette
r rate of discharge without sequelae (73% vs 52%; p = 0.02). Among the
cases with a CSF culture positive for Haemophilus influenzae, 77% wer
e discharged without sequelae in group 2 compared with 51% in group I
(p = 0.03). The addition of dexamethasone to standard antibiotic treat
ment improves the outcome of children between 6 and 59 months of age a
dmitted to hospital with a diagnosis of bacterial meningitis.