1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-2-77 10.15844/pedneurbriefs-2-10-7 CNS Infections Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Bacterial Menigitis and Deafness http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 11 1988 01 08 2016 2 10 77 78 Copyright: © 1988 The Author(s) 1988 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dexamethasone therapy for bacterial meningitis. Results of two double-blind, placebo-controlled trials

Dexamethasone (.15 mg/kg/bwt q 6 hr for 4 days) was considered beneficial in the treatment of infants and children with bacterial meningitis, particularly in preventing deafness, in two double blind, placebo-controlled trials involving 200 patients treated in the Dept of Pediatrics, University of Texas at Southwestern Medical Center, Dallas, TX.

 Bacterial Menigitis Dexamethasone Auditory Acuity

Dexamethasone (.15 mg/kg/bwt q 6 hr for 4 days) was considered beneficial in the treatment of infants and children with bacterial meningitis, particularly in preventing deafness, in two double blind, placebo-controlled trials involving 200 patients treated in the Dept of Pediatrics, University of Texas at Southwestern Medical Center, Dallas, TX. As compared to 98 patients receiving placebo, 102 treated with dexamethasone became afebrile earlier (1.6 vs 5 days;P<.001) and were less likely to acquire bilateral sensorineural hearing loss (15.5 vs 3.3%; P<.01). Twelve patients in the 2 placebo groups (14%) had severe bilateral loss as compared with 1(1%)) in the 2 dexamethasone groups (P<.001). [1]

COMMENT. An editorial in the same issue [2] applauds the investigators for undertaking a difficult and complex study but notes that enthusiasm for the findings is dampened by the lack of follow-up of all patients enrolled in the study. The patients may have been restudied too early to detect improvement in auditory acuity of controls, and the dexamethasone group may have been less severely ill than the controls. An assessment of higher cortical function one year after discharge revealed no significant difference in treatment and control groups. Dexamethasone in the treatment of a severely ill child with meningitis may be recommended but a confirmatory study documenting safety is advised to determine its necessity in mild cases. Dexamethasone may save the hearing but worsen cerebal cortical function by ischemic injury and may induce gastrointestinal bleeding.

 Lebel MH Freij BJ Syrogiannopoulos GA Chrane DF Hoyt MJ Stewart SM Dexamethasone therapy for bacterial meningitis. Results of two double-blind, placebo-controlled trials N Engl J Med 1988 Oct 13 319 15 964 71 3047581 Smith AL Neurologic sequelae of meningitis N Engl J Med 1988 Oct 13 319 15 1012 4 10.1056/NEJM198810133191510 3419468