Navigation Links
Corticosteroids of Little Use Against Childhood Meningitis
Date:5/6/2008

Study finds no significant effect for the more serious, bacterial form of the disease

TUESDAY, May 6 (HealthDay News) -- Corticosteroids are increasingly used to help treat children with bacterial meningitis, but a new study finds that adding the drugs to antibiotic treatment may not reduce death rates or the length of hospital stays.

But the study -- which involved 2,780 children treated for this potentially lethal infection of tissues lining the brain -- isn't the last word on the issue, said senior researcher Dr. Samir S. Shah, an infectious diseases specialist at the Children's Hospital of Philadelphia.

One reason is that the death rate from the infection in children is so low that a real difference is statistically hard to demonstrate, Shah said. Mortality among adults with bacterial meningitis runs as high as 30 percent, while in children "it is quite low, in the 4 to 5 percent range," he said.

So the study results didn't exclude the possibility that a benefit from corticosteroids could exist, Shah said, but "if it does, it is very small."

His team published its findings in the May 7 issue of the Journal of the American Medical Association.

In the study, just 248 of the nearly 2,800 children treated at 27 U.S. pediatric hospitals received corticosteroids, about 9 percent of the total. However, steroid use among youngsters with the illness doubled during the study period -- from under 6 percent in 2001 to 12 percent in 2006.

The overall death rate for children getting corticosteroids was 6 percent, compared to 4 percent among those not getting them. Hospital stays averaged 12 days for children getting corticosteroids and 10 days for those not receiving them. Neither difference was statistically significant, meaning this outcome could have happened by chance.

Shah himself pointed out what he saw as a flaw of the study: It did not consider the neurological damage done by meningitis, such as hearing loss. Some studies have indicated that corticosteroid treatment might reduce such damage, he said.

"The way I would want people to use our study is not to say there does not seem to be a benefit, or that [corticosteroids] should be used routinely, but to regard it as an impetus for a large, randomized trial," Shah said. "At this point, it would seem that the benefits do not outweigh the risks of using corticosteroids in children, but we need a large-scale clinical trial looking at neurological damage before deciding yes or no."

The study had another flaw, said Dr. Robert W. Frenck, a professor of pediatrics in the division of infectious diseases at Cincinnati Children's Hospital Medical Center: It did not include information on when in the course of the infection corticosteroids were given.

"A number of studies with animals and humans have shown that using corticosteroids before the first dose of antibiotics has the most benefit," Frenck said. "It reduces the inflammatory response that results when the immune system kills the bacteria."

Physicians who treat meningitis are likely to say that the study supports whatever they are now doing, he said. "If people are in the camp where corticosteroids are not regarded as helpful, they will say this shows that they don't help," Frenck said. "If they are in the camp where they are seen as beneficial, they will say that the study does not disprove it."

The large-scale trial proposed by Shah is not likely to happen, Frenck said, and for a cheerful reason -- the very low incidence of bacterial meningitis among American children. Vaccines against the bacteria that cause meningitis, such as Hemophilus influenzae type B, have successfully reduced the incidence of the disease, Frenck said. For that reason, bacterial meningitis now occurs in about eight in every 100,000 American children.

"The vaccines have had a tremendous effect," Frenck said. "What you want to do is prevent it."

More information

Learn about meningitis from the U.S. Library of Medicine.



SOURCES: Samir S. Shah, M.D., infectious disease specialist, Children's Hospital of Philadelphia; Robert W. Frenck, M.D., professor, pediatrics, Cincinnati Children's Hospital Medical Center; May 7, 2008, Journal of the American Medical Association


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Come to Maggianos Little Italy(R) to Eat-A-Dish for Make-A-Wish(R)
2. New Independent Research Firm Targets Firms with Little or No Analyst Following
3. Cranberries: The Little Fruit With a Great Big Punch
4. Study finds media coverage of breast cancer focuses too little on prevention
5. Too Little Sleep Leads to Too Much Weight for Kids
6. Alzheimers vaccine clears plaque but has little effect on learning and memory impairment
7. Antipsychotic Drugs of Little Benefit to Alzheimers Patients
8. Too Little Vitamin D May Soften Babys Skull
9. MRIs high false positive rate has little impact on womens choice of preventive mastectomy
10. Universal Screening for MRSA in Hospitals Made Little Difference
11. Antibiotics Do Little for Inner Ear Infections
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Corticosteroids of Little Use Against Childhood Meningitis
(Date:12/2/2016)... OH (PRWEB) , ... December 02, 2016 , ... ... of veterinarian diagnostic imaging systems and the first company to offer ... With a Heart at their tradeshow booth # 941 for the American Association ...
(Date:12/2/2016)... ... December 02, 2016 , ... Yisrayl Hawkins, at The House of Yahweh in ... fits into Bible Prophecy. Yisrayl says this generation, known as the Last Generation, started ... how the details line up exactly with Bible Prophecy – a protected way for ...
(Date:12/2/2016)... ... December 02, 2016 , ... On ... individuals and families from eight different sites throughout Miami-Dade and Broward counties. This ... volunteers worked very hard on Thanksgiving morning by putting together individual meals via ...
(Date:12/2/2016)... ... 2016 , ... ‘Tis the season for giving! Today, 20 creative teams across ... Partnership and the Drug Enforcement Administration as part of the National Red Ribbon Week ... schools who decorated their campuses with this year’s Red Ribbon Week theme: “YOLO. Be ...
(Date:11/30/2016)... ... November 30, 2016 , ... "I hate when the mixture of saliva ... teeth," said an inventor from Bridgewater, N.J. "I thought that there had to be ... , He developed the patent-pending DEFLECTOR to prevent saliva and toothpaste from running down ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... , December 2, 2016 ... Vitro Diagnostics/IVD Market by Product (Instruments, Reagents, Software), ... (Diabetes, Oncology, Cardiology, Nephrology, Infectious Diseases) - Forecast ... is valued at USD 60.22 Billion in 2016. ... CAGR of 5.5% during the forecast period (2016-2021) ...
(Date:12/2/2016)...  PipelineRx, a leading medication management technology company ... of its SaaS-based telepharmacy platform, PowerGridRx™ , ... Midyear Clinical Meeting and Exhibition, December 5-7 in ... 300 hospital clients nationally, the Company is a ... dramatically improve pharmacy operations, enhance patient safety, and ...
(Date:12/2/2016)... -- On Thursday, December 1st 2016, the ... development and innovation in the biopharmaceutical industry at its ... the presence of Sergey Tsyb, Vice Minister of Industry ... , Natalia Sanina, First Vice Chairman of the State ... Roszdravnadzor, National Service of Control in Healthcare, Sergey Muravev, ...
Breaking Medicine Technology: