de Gans 2002
Dexamethasone in Adults with Bacterial Meningitis
Patient / Population Intervention / Exposure Comparison Outcome
In 301 adults with suspected community-acquired bacterial meningitis, dexamethasone 10 mg every 6 h for 4 days started before or with the first antibiotic dose reduced unfavourable outcome and mortality compared with placebo.
N
301
Design
Double-blind RCT
Endpoint
Unfavourable Glasgow Outcome Score at 8 weeks
Relevance
1
ResultUnfavourable outcome 15 % vs 25 %; mortality 7 % vs 15 %; benefit driven by S. pneumoniae subgroup.
de Gans J, van de Beek D. N Engl J Med. 2002;347(20):1549-1556. 10.1056/NEJMoa021334
Discussion & critique
Adjunctive dexamethasone with/before the first antibiotic dose is standard in high-income settings — continued only if pneumococcal disease is confirmed.