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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
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