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.



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

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s