STEROID-THERAPY FOR BACTERIAL-MENINGITIS IN CHILDREN

Steroid therapy combined with antibiotics for bacterial meningitis in pediatric patients remains controversial. Steroids, and primarily dexa methasone, a very potent anti-inflammatory agent, regulate the Liberat ion of various cytokines and inflammatory mediators such as prostaglan dins, released during bacterial meningitis which may lead to long term complications, Several clinical trials studying infants and children with bacterial meningitis due to Haemophilus influenzae have assessed the beneficial effects of administering dexamethasone at the onset of antibiotherapy and have demonstrated that dexamethasone reduced the ri sk of acquired deafness (bilateral, moderate, or more severe hearing l oss) and the incidence of neurological sequela. Limited information is available for other bacterial meningitis, However, meningococcal meni ngitis will become more frequent than Haemophilus meningitis due to th e efficacy of the haemophilus vaccine. Some S. pneumoniae are now resi stant to third generation cephalosporins and using dexamethasone in th at case may be hazardous. Furthermore, no evidence is available as to the effective role of dexamethasone in neonatal bacterial meningitis, although it is quite often administered in that age group.