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Anti-Inflammatory Helps Treat Bacterial Meningitis: Study
Date:9/29/2010

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Sept. 29 (HealthDay News) -- Using the anti-inflammatory drug dexamethasone along with antibiotics increases the chance of surviving a bout with bacterial meningitis, Dutch researchers report.

"Dexamethasone therapy reduces mortality from bacterial meningitis by one-third," said lead researcher Dr. Diederik van de Beek, a clinical neurologist from the Academic Medical Center at the University of Amsterdam.

"That's a huge effect," he added. "Normally, the death rate of bacterial meningitis is 30 percent; if you use dexamethasone, it decreases to 20 percent."

The report is published in the Sept. 29 online edition and the Oct. 26 print issue of Neurology.

For the study, van de Beek's team collected data on 357 people 16 and older who had bacterial meningitis between 2006 and 2009. Of these patients, 84 percent were given a dose of dexamethasone, a corticosteroid, before antibiotic treatment was started.

The researchers compared the outcomes of these patients with 352 patients treated for bacterial meningitis between 1998 and 2002, before dexamethasone was routinely given for the infection. Among these patients, only 3 percent had been given dexamethasone, the researchers noted.

Deaths among those given dexamethasone in the 2006-2009 study group were 10 percent lower than for those in the early study group. In addition, hearing loss was almost 10 percent lower for people in the 2006-2009 study group compared with the earlier group, the investigators found.

"If you extrapolate these findings to the U.S., if you treat all patients with bacterial meningitis with dexamethasone, that would save one life every day," van de Beek said.

Guidelines in the United States recommend the use of dexamethasone for suspected cases of bacterial meningitis, he added.

Jeffrey Cirillo, an associate professor of microbial and molecular pathogenesis at Texas A&M Health Science Center College of Medicine, said that the study's results confirmed previous findings in clinical trials and laboratory models that dexamethasone treatment in combination with antibiotics can reduce mortality in patients.

"These results strongly support the use of dexamethasone in cases of pneumococcal meningitis and offer promise to improve the chances of survival from meningitis, a frequently deadly illness," Cirillo added.

Since 2000, a vaccine against bacterial meningitis has been available. A study last year confirmed that the vaccine has significantly cut the number of cases of the disease.

Overall, the number of cases of the disease dropped 30 percent in that time, but the effect on the very youngest and oldest was even more pronounced: Incidence decreased by 64 percent in those younger than 2 and by 54 percent in those older than 65, according to the report, published in the Jan. 15, 2009 issue of the New England Journal of Medicine.

The vaccine, known as Prevnar and made by Wyeth Pharmaceuticals, is part of the standard vaccination recommendation for children in the United States ages 2 to 23 months, as well as for children 24 to 59 months old who are at high risk for pneumococcal disease.

Meningitis causes inflammation to the membranes in the brain and spinal cord. Bacterial meningitis, unlike viral meningitis, can be deadly and can also cause hearing loss, brain damage and learning disabilities. The most common and severe form of bacterial meningitis is pneumococcal meningitis. About 30 percent of people with bacterial meningitis die from it, according to background information provided in a news release from the American Academy of Neurology.

More information

For more information on bacterial meningitis, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Diederik van de Beek, M.D., Ph.D., clinical neurologist, Academic Medical Center, University of Amsterdam, the Netherlands; Jeffrey Cirillo, Ph.D., associate professor, microbial and molecular pathogenesis, Texas A&M Health Science Center College of Medicine, College Station, Texas; Sept. 29, 2010, Neurology, online


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