Prevention of hearing loss in experimental pneumococcal meningitis by administration of dexamethasone and ketorolac

Pneumococcal meningitis remains a significant cause of morbidity, particula rly sensorineural hearing loss. Recent literature has suggested that a vigo rous host immune response to Staphylococcus pneumoniae is responsible for m uch of the neurologic sequelae, including deafness, after bacterial meningi tis. This study used a rabbit model of hearing loss in experimental pneumoc occal meningitis to evaluate the therapeutic effect of two anti-inflammator y agents, dexamethasone and ketorolac, coadministered with ampicillin, Both adjunctive drugs minimized or prevented sensorineural hearing loss compare d with placebo. Dexamethasone, administered 10 min before ampicillin, was p articularly effective in minimizing mean hearing threshold change compared with placebo for both clicks (dexamethasone: 6.7-dB sound pressure level [S PL] vs, placebo: 33.4-dB SPL, P = .0078) and 10-kHz tone bursts (dexamethas one: 8.4-dB SPL vs. placebo: 53.4-dB SPL, P = .0003), These findings suppor t the beneficial role of anti-inflammatory agents in reducing the incidence of hearing loss from pneumococcal meningitis, especially if therapy is ins tituted early in the course of infection.