Even in high-income countries, the benefit of corticosteroids is only seen when they are given prior to the first dose of antibiotics, and is greatest in cases of H. influenzae meningitis, the incidence of which has decreased dramatically since the introduction of the Hib vaccine.
Bahkan di negara berpenghasilan tinggi, manfaat kortikosteroid hanya terlihat bila diberikan sebelum dosis pertama antibiotik, dan manfaat terbesar terlihat dalam kasus meningitis H. influenzae, insidennya sudah menurun secara dramatis sejak Vaksin hib diperkenalkan.