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-5-96 10.15844/pedneurbriefs-5-12-10 Infectious Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Corticosteroids in Pneumococcal Meningitis 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 12 1991 01 07 2016 5 12 96 96 Copyright: © 1991 The Author(s) 1991 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. The role of corticosteroid therapy in children with pneumococcal meningitis

The records of 97 infants and children with pneumococcal meningitis, 41 receiving corticosteroid therapy, were examined at the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.

 Corticosteroid Pneumococcal Meningitis Dexamethasone

The records of 97 infants and children with pneumococcal meningitis, 41 receiving corticosteroid therapy, were examined at the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas. When steroid-therapy was given before or concurrently with antibiotic therapy, none of 30 steroid-treated versus 16 of 52 non-steroid-treated patients developed neurologic or cardiovascular instability after the first parenteral antibiotic dose was given. Bilateral moderate or greater hearing loss occurred in 9% of steroid-treated group compared to 21% of non-steroid group. The incidence of hearing loss was significantly lower in those survivors of overwhelming meningeal infection who had been treated with steroids. [1]

COMMENT. The data from this study were obtained retrospectively and a placebo-controlled double-blind study of dexamethasone in pneumococcal meningitis is indicated. The beneficial effect of corticosteroid adjunctive therapy has been demonstrated previously only in patients with Haemophilus meningitis. Since the incidence of H. influenzae meningitis will be reduced by immunization in the future, S. pneumoniae or N. meningitidis will be the causal agent in a larger percentage of children [2]. Dexamethasone in childhood meningitis is discussed in the correspondence section of this issue of The N Engl J Med. A retrospective evaluation of 12 years experience in the treatment of neonatal meningitis is reported from The Departments of Paediatrics and Bacteriology, Goteborg and Molndal, University of Goteborg, Sweden [3]. Initial treatment with ampicillin-aminoglycoside combination failed in 6 of 34 patients, despite organism sensitivity to the antibiotics.

 Kennedy WA Hoyt MJ McCracken GH Jr The role of corticosteroid therapy in children with pneumococcal meningitis Am J Dis Child 1991 Dec 145 12 1374 1378 10.1001/archpedi.1991.02160120042016 1669663 Schuster V Kreth HW N Engl J Med 1991 Dec 5 325 1654 Tessin I Trollfors B Thiringer K Larsson P Ampicillin-aminoglycoside combinations as initial treatment for neonatal septicaemia or meningitis. A retrospective evaluation of 12 years’ experience Acta Paediatr Scand 1991 Oct 80 10 911 916 10.1111/j.1651-2227.1991.tb11752.x 1755296