Adjunctive therapy with dexamethasone should be considered in selected cases of bacterial meningitis in infants and children. Dexamethasone has reduced hearing impairment in children with Haemophilus influenza type b meningitis when given with or before starting antimicrobial therapy.
What are the indications for the addition of dexamethasone to the medication regimen in a child with bacterial meningitis?
----MD
Adjunctive therapy with dexamethasone should be considered in selected cases of bacterial meningitis in infants and children. Dexamethasone has reduced hearing impairment in children with Haemophilus influenza type b meningitis when given with or before starting antimicrobial therapy.
However, data are insufficient to demonstrate a clear benefit of adjunctive dexamethasone therapy in children with pneumococcal meningitis. Therefore, clear indications for its use are not available in these cases. The use of dexamethasone in these patients may be considered after weighing the potential benefits and possible risks on a case-by-case basis, according to expert opinion.
When used, dexamethasone should be given immediately before or at the time antibiotics are started. Once antimicrobial therapy has begun, dexamethasone is unlikely to improve the outcome of patients with bacterial meningitis.
The safety and efficacy of adjunctive dexamethasone therapy in meningitis caused by other bacteria are not known. Dexamethasone is not recommended as part of the therapeutic regimen for bacterial meningitis in neonates.
----Susana Chavez-Bueno, MD Clinical Assistant Professor Department of Pediatrics Section of Community Pediatrics University of Oklahoma Health Sciences Center Oklahoma City
Continuous glucose monitors ease care for parents of young children with T1D
December 5th 2023Continuous glucose monitors have been found to improve sleep for parents of young children with type 1 diabetes and may help alleviate the care burden associated with the condition, according to a study conducted in France.
AAP cautions against low-carbohydrate diets for children at risk for diabetes
December 1st 2023According to the American Academy of Pediatrics (AAP), it is recommended that 45% to 65% of total daily calories come from carbohydrates, though very low-carbohydrate diets allow for 20 to 50 grams per day.