Steroid for Meningitis

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.

 

Reference:

Gaieski, D., O’Brien, N. and Hernandez, R. (2017). Emergency Neurologic Life Support: Meningitis and Encephalitis. Neurocritical Care, 27(S1), pp.124-133.

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