Corticosteroid Use in Childhood Meningitis Needs Review

May 6, 2008

The use of adjuvant corticosteroid therapy in children with bacterial meningitis wasn't associated with survival or length of hospital stay, according to research published in the May 7 issue of the Journal of the American Medical Association.

TUESDAY, May 6 (HealthDay News) -- The use of adjuvant corticosteroid therapy in children with bacterial meningitis wasn't associated with survival or length of hospital stay, according to research published in the May 7 issue of the Journal of the American Medical Association.

Jillian Mongelluzzo, of The Children's Hospital of Philadelphia, and colleagues analyzed data from 2,780 children (median age 9 months) who were discharged with bacterial meningitis as the primary diagnosis, over a six-year period. The primary outcomes of interest were time to death and time to hospital discharge. Although adjuvant corticosteroids reduce mortality in adults with bacterial meningitis, their use has shown conflicting results in children.

Adjuvant corticosteroids didn't reduce mortality, regardless of the age group of children, nor were they associated with time to discharge. The results remained the same whether the children were identified with pneumococcal or meningococcal meningitis, the report indicates.

"In conclusion, this multicenter observational study found that adjuvant corticosteroid therapy was not associated with survival or time to hospital discharge in children with bacterial meningitis. However, adjuvant corticosteroid use in the treatment of bacterial meningitis appears to be increasing. A randomized trial is warranted to explore the possible benefit of adjuvant corticosteroid therapy on both morbidity and mortality in children with bacterial meningitis before such corticosteroid use becomes routine," the authors conclude.

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