Lack of effectiveness of dexamethasone in neonatal bacterial meningitis

A clinical trial was conducted to determine whether dexamethasone as adjunc tive therapy alters the outcome of bacterial meningitis in neonates. Fifty- two fullterm neonates with bacterial meningitis were enrolled in a prospect ive study. Infants were alternately assigned to receive either dexamethason e or not. Twenty-seven received dexamethasone in addition to standard antib iotic treatment and 25 received antibiotics alone. Dexamethasone therapy wa s started 10-15 min before the first dose of antibiotics in a dose of 0.15 mg/kg per 6 h for 4 days. Baseline characteristics, clinical and laboratory features in the two groups were virtually similar. Both groups showed a si milar clinical response and similar frequency of mortality and sequelae. Si x (22%) babies in the treatment group died compared to 7 (28%) in the contr ol group (P = 0.87). At follow up examinations up to the age of 2 years, 6 (30%) of dexamethasone recipients and 7 (39%) of the control group had mild or moderate/severe neurological sequelae. Audiological sequelae were seen in two neonates in the dexamethasone group compared to one in the control g roup. Conclusion Adjunctive dexamethasone therapy does not improve the outcome of neonatal bacterial meningitis.