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Steroid Fails to Ease Meningitis in Trials
Date:12/12/2007

But results from Asia, Africa may not apply to patients in the West, experts say

WEDNESDAY, Dec. 12 (HealthDay News)-- Disappointing the hopes of researchers, new trials using a powerful steroid to treat deadly bacterial meningitis have shown little or no benefit from the drugs.

"It was a surprise," said Dr. Matthew Scarborough, a clinical lecturer in infectious diseases at the University of Malawi College of Medicine, and the lead author of one study. "Following publication of a European trial that showed benefits, our results showed none," he said.

The results of the two trials, which were conducted in Vietnam and in the south African nation of Malawi, are published in the Dec. 13 issue of the New England Journal of Medicine.

Despite the results, guidelines for the treatment of bacterial meningitis in the United States will almost certainly continue to recommend use of steroids, in part because of the positive results of the 2003 European trial, Scarborough said.

He noted that there were significant differences between the patients treated in that trial and the 465 participants in the Malawi trial.

"Ninety percent of the patients in Malawi had HIV co-infections," Scarborough said. "They also presented later in the disease. Also there was a high incidence of neurological complications. We don't know which of these factors explains the results."

Meningitis is an infection of the spinal fluid (meninges) that surrounds the spinal cord and brain. The illness can be caused by a virus (typically less severe) or, more rarely, by bacteria. Bacterial meningitis is considered much more dangerous, even lethal.

In the Malawi study, researchers gave participants suspected of having bacterial meningitis either the corticosteroid dexamethasone plus an antibiotic, ceftriaxone, or ceftriaxone alone.

Overall, there was no difference in the incidence of death, disability and
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