Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data

The Lancet Neurology

Volumn 9, Issue 3, 2010, Pages 254-263

  van de Beek, Diederik ^a   Farrar, Jeremy J ^b,c,f   de Gans, Jan ^a   Mai, Nguyen Thi Hoang ^b   Molyneux, Elizabeth M ^d   Peltola, Heikki ^e   Peto, Tim E ^g   Roine, Irmeli ^h   Scarborough, Mathew ^d,f   Schultsz, Constance ^a,c   Thwaites, Guy E ⁱ   Tuan, Phung Quoc ^b,c   Zwinderman, AH ^a  

^a ACADEMIC MEDICAL CENTER   (Netherlands)

^b UNIVERSITY COLLEGE LONDON HOSPITALS   (United Kingdom)

^c OXFORD UNIVERSITY CLINICAL RESEARCH UNIT   (Viet Nam)

^d UNIVERSITY OF MALAWI   (Malawi)

^e HELSINKI UNIVERSITY CENTRAL HOSPITAL   (Finland)

^f UNIVERSITY OF OXFORD   (United Kingdom)

^g JOHN RADCLIFFE HOSPITAL   (United Kingdom)

^h UNIVERSIDAD DIEGO PORTALES   (Chile)

ⁱ IMPERIAL COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

AMOXICILLIN; ANTIBIOTIC AGENT; CEFTRIAXONE; CHLORAMPHENICOL; DEXAMETHASONE; GLYCEROL; PENICILLIN G; PLACEBO;

ADJUVANT THERAPY; AGE DISTRIBUTION; ANTIBIOTIC THERAPY; ARTICLE; BACTERIAL MENINGITIS; CLINICAL TRIAL; CONFIDENCE INTERVAL; CORTICOSTEROID THERAPY; DEATH; FOLLOW UP; GASTROINTESTINAL HEMORRHAGE; HEARING LOSS; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; HYPERGLYCEMIA; LOGISTIC REGRESSION ANALYSIS; MALNUTRITION; MANTEL HAENSZEL TEST; META ANALYSIS; MORTALITY; OUTCOME ASSESSMENT; PRIORITY JOURNAL; SURVIVOR; SYSTEMATIC REVIEW; VIRUS INFECTION;

ADOLESCENT; ADULT; CHILD; CHILD, PRESCHOOL; DEXAMETHASONE; DRUG THERAPY, COMBINATION; FEMALE; HUMANS; INFANT; MALE; MENINGITIS, BACTERIAL; MIDDLE AGED; RANDOMIZED CONTROLLED TRIALS AS TOPIC; YOUNG ADULT;

EID: 76449121189     PISSN: 14744422     EISSN: None     Source Type: Journal    
DOI: 10.1016/S1474-4422(10)70023-5     Document Type: Article

References (39)

1. van de Beek D., de Gans J., Spanjaard L., Weisfelt M., Reitsma J.B., and Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351 (2004) 1849-1859
2. van de Beek D., de Gans J., Tunkel A.R., and Wijdicks E.F. Community-acquired bacterial meningitis in adults. N Engl J Med 354 (2006) 44-53
3. Saez-Llorens X., and McCracken Jr. G.H. Bacterial meningitis in children. Lancet 361 (2003) 2139-2148
4. Scarborough M., and Thwaites G.E. The diagnosis and management of acute bacterial meningitis in resource-poor settings. Lancet Neurol 7 (2008) 637-648
5. Scheld W.M., Dacey R.G., Winn H.R., Welsh J.E., Jane J.A., and Sande M.A. Cerebrospinal fluid outflow resistance in rabbits with experimental meningitis: alterations with penicillin and methylprednisolone. J Clin Invest 66 (1980) 243-253
6. Tauber M.G., Khayam-Bashi H., and Sande M.A. Effects of ampicillin and corticosteroids on brain water content, cerebrospinal fluid pressure, and cerebrospinal fluid lactate levels in experimental pneumococcal meningitis. J Infect Dis 151 (1985) 528-534
7. van de Beek D., Weisfelt M., de Gans J., Tunkel A.R., and Wijdicks E.F. Drug insight: adjunctive therapies in adults with bacterial meningitis. Nat Clin Pract Neurol 2 (2006) 504-516
8. van de Beek D., de Gans J., McIntyre P., and Prasad K. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev 1 (2007) CD004405.
9. Havens P.L., Wendelberger K.J., Hoffman G.M., Lee M.B., and Chusid M.J. Corticosteroids as adjunctive therapy in bacterial meningitis: a meta-analysis of clinical trials. Am J Dis Child 143 (1989) 1051-1055
10. McIntyre P.B., Berkey C.S., King S.M., et al. Dexamethasone as adjunctive therapy in bacterial meningitis: a meta-analysis of randomized clinical trials since 1988. JAMA 278 (1997) 925-931
11. van de Beek D., de Gans J., McIntyre P., and Prasad K. Steroids in adults with acute bacterial meningitis: a systematic review. Lancet Infect Dis 4 (2004) 139-143
12. Peltola H., Roine I., Fernandez J., et al. Adjuvant glycerol and/or dexamethasone to improve the outcomes of childhood bacterial meningitis: a prospective, randomized, double-blind, placebo-controlled trial. Clin Infect Dis 45 (2007) 1277-1286
13. Nguyen T.H., Tran T.H., Thwaites G., et al. Dexamethasone in Vietnamese adolescents and adults with bacterial meningitis. N Engl J Med 357 (2007) 2431-2440
14. Scarborough M., Gordon S.B., Whitty C.J., et al. Corticosteroids for bacterial meningitis in adults in sub-Saharan Africa. N Engl J Med 357 (2007) 2441-2450
15. Molyneux E.M., Walsh A.L., Forsyth H., et al. Dexamethasone treatment in childhood bacterial meningitis in Malawi: a randomised controlled trial. Lancet 360 (2002) 211-218
16. de Gans J., and van de Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med 347 (2002) 1549-1556
17. Belsey M.A., Hoffpauir C.W., and Smith M.H. Dexamethasone in the treatment of acute bacterial meningitis: the effect of study design on the interpretation of results. Pediatrics 44 (1969) 503-513
18. Bademosi O., and Osuntokun B.O. Prednisolone in the treatment of pneumococcal meningitis. Trop Geograph Med 31 (1979) 53-56
19. Bhaumik S., and Behari M. Role of dexamethasone as adjunctive therapy in acute bacterial meningitis in adults. Neurol India 46 (1998) 225-228
20. Ciana G., Parmar N., Antonio C., Pivetta S., Tamburlini G., and Cuttini M. Effectiveness of adjunctive treatment with steroids in reducing short-term mortality in a high-risk population of children with bacterial meningitis. J Trop Pediatr 41 (1995) 164-168
21. deLemos R.A., and Haggerty R.J. Corticosteroids as an adjunct to treatment in bacterial meningitis: a controlled clinical trial. Pediatrics 44 (1969) 30-34
22. Girgis N.I., Farid Z., Mikhail I.A., Farrag I., Sultan Y., and Kilpatrick M.E. Dexamethasone treatment for bacterial meningitis in children and adults. Pediatr Infect Dis J 8 (1989) 848-851
23. Kanra G.Y., Ozen H., Secmeer G., Ceyhan M., Ecevit Z., and Belgin E. Beneficial effects of dexamethasone in children with pneumococcal meningitis. Pediatr Infect Dis J 14 (1995) 490-494
24. Lebel M.H., Freij B.J., Syrogiannopoulos G.A., et al. Dexamethasone therapy for bacterial meningitis. Results of two double-blind, placebo-controlled trials. N Engl J Med 319 (1988) 964-971
25. Odio C.M., Faingezicht I., Paris M., et al. The beneficial effects of early dexamethasone administration in infants and children with bacterial meningitis. N Engl J Med 324 (1991) 1525-1531
26. Qazi S.A., Khan M.A., Mughal N., et al. Dexamethasone and bacterial meningitis in Pakistan. Arch Dis Child 75 (1996) 482-488
27. Thomas R., Le T.Y., Bouget J., et al. Trial of dexamethasone treatment for severe bacterial meningitis in adults: adult Meningitis Steroid Group. Intensive Care Med 25 (1999) 475-480
28. Jennett B., and Bond M. Assessment of outcome after severe brain damage. Lancet 1 (1975) 480-484
29. UK-TIA Study Group. United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: interim results. BMJ 296 (1988) 316-320
30. Bennett I.L., Finland M., Hamburger M., Kass E.H., Lepper M., and Waisbren N. The effectiveness of hydrocortisone in the management of severe infections. JAMA 183 (1963) 462-465
31. King S.M., Law B., Langley J.M., Heurtler H., Bremner D., and Wang E.E. Dexamethasone therapy for bacterial meningitis: better never than late?. Can J Infect Dis 5 (1994) 210-215
32. Lebel M.H., Hoyt J., Waagner D.C., Rollins N.K., Finitzo T., and McCracken G.H. Magnetic resonance imaging and dexamethasone therapy for bacterial meningitis. Am J Dis Child 143 (1989) 301-306
33. Wald E.R., Kaplan S.L., Mason E.O., et al. Dexamethasone therapy for children with bacterial meningitis. Pediatrics 95 (1995) 21-28
34. Kilpi T., Peltola H., Jauhiainen T., et al. Oral glycerol and intravenous dexamethasone in preventing neurologic and audiological sequelae of childhood bacterial-meningitis. Pediatr Infect Dis J 14 (1995) 270-278
35. Schaad U.B., Lips U., Gnehm H.E., Blumberg A., Heinzer I., and Wedgwood J. Dexamethasone therapy for bacterial meningitis in children. Lancet 342 (1993) 457-461
36. van de Beek D., and de Gans J. Dexamethasone in adults with community-acquired bacterial meningitis. Drugs 66 (2006) 415-427
37. Tunkel A.R., Hartman B.J., Kaplan S.L., et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39 (2004) 1267-1284
38. Fitch M.T., and van de Beek D. Drug insight: steroids in CNS infectious diseases-new indications for an old therapy. Nat Clin Pract Neurol 4 (2008) 97-104
39. Greenwood B.M. Corticosteroids for acute bacterial meningitis. N Engl J Med 357 (2007) 2507-2509