Meningitis: Steroids or not?17 November, 2011 by: colinparker
The most important thing about treating meningitis is to give antibiotics as soon as possible. The second most important thing is to institute appropriate supportive care. Whether or not to give steroids as an adjunctive treatment is perhaps less clear to us…
A recent Cochrane review goes a long way to pointing us in the right direction, but still leaves a few questions open. Join us for a quick tour of the literature and guidelines, in our quest for the truth about using steroids in meningitis.
Outline: Steroids for Meningitis PEMcast
[cp]: intro, disclaimer, rationale / theory: decrease inflammatory damage due to bacterial lysis
[cp]: Historical background: original studies were from an era when Haemophilus & Strep were common, decreased by vaccinations
?applicability to current (developed world) population of children and infectious agents
[CB]: Comments from Chris
Review of NICE Guidance by Radcliffe, October 2011
[RR]: SIGN Guideline (esp section 6.4.2) Invasive MCD, start within 24 hours
[cp/CB]: local guidelines (dexamethasone 0.2mg/kg IV 6-hourly)
[all] Summary, goodbye
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The role of corticosteroid therapy in children with pneumococcal meningitis.
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Gupta S, Tuladhar AB.
Does early administration of dexamethasone improve neurological outcome in children with meningococcal meningitis?
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Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D.
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American Academy of Pediatrics Committee on Infectious Diseases:
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National Institute for Health and Clinical Excellence
The management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care
Last updated: 10 November 2011
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