WEDNESDAY, Dec. 12 (HealthDay News) -- A study of adults in sub-Saharan Africa with acute bacterial meningitis showed no benefit of corticosteroid adjuvant therapy, while a study of Vietnamese adults and adolescents reported a beneficial effect in only those with microbiologically confirmed disease, according to research published in the Dec. 13 issue of the New England Journal of Medicine.
Matthew Scarborough, of the College of Medicine in Blantyre, Malawi, and colleagues randomized 465 adults with presumed acute bacterial meningitis, of whom 90 percent were HIV-positive, to receive ceftriaxone plus either dexamethasone or placebo. Risk of death, disability, hearing impairment and adverse events did not differ between the two groups.
In the second study, Nguyen Thi Hoang Mai, M.D., of the Hospital for Tropical Diseases in Ho Chi Minh City in Vietnam, and colleagues randomized 435 patients over age 14 with suspected bacterial meningitis to receive either dexamethasone or placebo, in addition to antibiotics. In patients with confirmed bacterial meningitis, dexamethasone was associated with lower risk of death at one month, and lower risk of death or disability at six months.
The author of an associated editorial writes, "the debate about the value of corticosteroids in acute bacterial meningitis will continue. However, it seems likely that in the developing world, the use of corticosteroids or other adjunctive therapies will have only a marginal effect on survival. The goal should be to prevent most forms of these devastating infections, which are associated with a high morbidity, through the widespread use of the conjugate vaccines that are becoming increasingly available."
Abstract - Scarborough
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Abstract - Mai
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Editorial
