DEXAMETHASONE ADJUNCTIVE THERAPY FOR BACTERIAL-MENINGITIS IN CHILDREN- A RETROSPECTIVE STUDY IN BRAZIL

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.