Dexamethasone and Pneumococcal Meningitis
Authors: Diederik van de Beek, Jan de Gans
Journal: Annals of Internal Medicine (2004)

Letters17 August 2004Dexamethasone and Pneumococcal MeningitisDiederik van de Beek, MD, PhD and Jan de Gans, PhDDiederik van de Beek, MD, PhDFrom Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, the Netherlands. and Jan de Gans, PhDFrom Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-4-200408170-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Dexamethasone reduces mortality rates in adults with pneumococcal meningitis (1).Objective: We wanted to determine whether the beneficial effect of dexamethasone on mortality rates in adults with pneumococcal meningitis is attributable to beneficial effects on neurologic or systemic complications.Methods and Findings: We did a post hoc analysis of the European Dexamethasone in Adulthood Bacterial Meningitis Study (1). We included patients who had pneumococcal meningitis proven by cerebrospinal fluid culture. Deaths within 14 days after admission were categorized; we chose a survival point of 14 days because deaths within this period were probably directly related to ...References1. de Gans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med. 2002;347:1549-56. [PMID: 12432041] CrossrefMedlineGoogle Scholar2. McMillan DA, Lin CY, Aronin SI, Quagliarello VJ. Community-acquired bacterial meningitis in adults: categorization of causes and timing of death. Clin Infect Dis. 2001;33:969-75. [PMID: 11528567] CrossrefMedlineGoogle Scholar3. Annane D, Sebille V, Charpentier C, Bollaert PE, Francois B, Korach JM, et al . Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288:862-71. [PMID: 12186604] CrossrefMedlineGoogle Scholar4. Annane D, Bellissant E, Bollaert PE, Briegel J, Keh D, Kupfer Y. Corticosteroids for treating severe sepsis and septic shock. Cochrane Database Syst Rev. 2004;:CD002243. [PMID: 14973984] MedlineGoogle Scholar5. Cooper MS, Stewart PM. Corticosteroid insufficiency in acutely ill patients. N Engl J Med. 2003;348:727-34. [PMID: 12594318] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Diederik van de Beek, MD, PhD; Jan de Gans, PhDAffiliations: From Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, the Netherlands. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCommunity‐acquired bacterial meningitis in patients of 80 years and olderPneumococcal Meningitis in Adults: A Prospective Nationwide Cohort Study Over a 20-year PeriodCSF Rhinorrhea and InfectionAcute Community-Acquired Bacterial MeningitisCommunity-acquired bacterial meningitisDramatic reduction of mortality in pneumococcal meningitisPneumococcal meningitis: Clinical-pathological correlations (meningene-path)Capnocytophaga canimorsus Meningitis: Three Cases and a Review of the LiteratureCorticosteroids for acute bacterial meningitisBacterial meningitisCorticosteroids for acute bacterial meningitisRespiratory Dysfunction in Ventilated Patients: Can Inspiratory Muscle Training Help?Diffuse Cerebral Intravascular Coagulation and Cerebral Infarction in Pneumococcal MeningitisCorticosteroids for acute bacterial meningitisImpact of bacterial meningitis‐associated conditions on pediatric inpatient resource utilizationInfectious Vasculopathy of Intracranial Large- and Medium-Sized Vessels in Neurological Intensive Care Unit: A Clinico-Radiological StudyCerebral infarction in bacterial meningitis: predictive factors and outcomeAcute and chronic meningitisCorticothérapie chez l'enfant (indications, modalités d'administration)Corticosteroids for acute adult bacterial meningitisKilling bacteria softly in the cerebrospinal fluid may be advantageous in bacterial meningitis*BACTERIAL MENINGITISClinical Features, Outcome, and Meningococcal Genotype in 258 Adults With Meningococcal MeningitisTwo commentaries on 'Corticosteroids for acute bacterial meningitis'Cochrane review: Corticosteroids for acute bacterial meningitisNeurocritical care of patients with central nervous system infectionsDexamethasone in Vietnamese Adolescents and Adults with Bacterial MeningitisNeurocritical care of patients with central nervous system infectionsBacterial meningitis: a review of effective pharmacotherapyBrain teasing effect of dexamethasoneN-Acetyl-L-Cystein bei bakterieller MeningitisCorticosteroids for acute bacterial meningitisOxidative stress in pneumococcal meningitis: A future target for adjunctive therapy?Attenuated cerebrospinal fluid leukocyte count and sepsis in adults with pneumococcal meningitis: a prospective cohort studyInfluence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniaemeningitisDetrimental role of delayed antibiotic administration and penicillin-nonsusceptible strains in adult intensive care unit patients with pneumococcal meningitis: The PNEUMOREA prospective multicenter study*Community-Acquired Bacterial Meningitis in Older PeopleDrug Insight: adjunctive therapies in adults with bacterial meningitisDexamethasone Increases Hippocampal Neuronal Apoptosis in a Rabbit Model of Escherichia coli MeningitisDexamethasone and prognostic factors in adults with bacterial meningitisStrategies to prevent neuronal damage in paediatric bacterial meningitisDexamethasone treatment in adults with pneumococcal meningitis: risk factors for deathClinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case seriesPneumococcal meningitis: a 21st century perspectiveCommunity-Acquired Bacterial Meningitis in AdultsDexamethasone in Adults with Community-Acquired Bacterial MeningitisClinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infectionBlocking of leukocyte accumulation in the cerebrospinal fluid augments bacteremia and increases lethality in experimental pneumococcal meningitisAdjunctive corticosteroids in adults with bacterial meningitisClinical Features and Prognostic Factors in Adults with Bacterial Meningitis 17 August 2004Volume 141, Issue 4Page: 327KeywordsAcute respiratory distress syndromeBacterial meningitisCerebrospinal fluidDeath ratesMeningitisPneumoniaRelative riskRespiratory failureSepsisShock ePublished: 17 August 2004 Issue Published: 17 August 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...