There is evidence for use of dexamethasone in bacterial meningitis caused by Streptococcus pneumoniae.
Empiric dexamethasone until cultures return is reasonable.
- reduces hearing loss in children with H. influenza type b meningitis
- mortality improved in meningitis caused by Streptococcus pneumonia.
IDSA guidelines state: “some authorities initiate dexamethasone in all adults with suspected bacterial meningitis because etiology is not always ascretained at initial evaluation.”
DOSE: dexamethasone 10mg IV q6h x 2-4d ideally 10-20mins before first dose of antibiotic.
PEDS: 0.15mg/Kg q6h x 2-4d for children.
Gaieski, D., O’Brien, N. and Hernandez, R. (2017). Emergency Neurologic Life Support: Meningitis and Encephalitis. Neurocritical Care, 27(S1), pp.124-133.