Navigation Links
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 severe complications between those who got the steroid and those who did not.

A trial of 435 patients with suspected bacterial meningitis patients treated in Vietnam showed similar results, with similar rates of death and disability at one and six months in groups that got steroids or did not. But a significantly lower rate of death and disability was found in patients where the suspected diagnosis of bacterial meningitis could be confirmed.

The Vietnam trial was led by Dr. Jeremy Farrar of the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.

The studies suggest that different treatment approaches may be needed in different locales, Scarborough said.

"At the moment, I don't think there is any reason for a change of guidelines in Europe and America," Scarborough said. "In Europe and America, patients will still get steroids as adjuvant therapy. There is no evidence that in Africa or Asia, there is a benefit in children or adults. The guidelines will have to be separated."

"The results of the newly reported studies are not entirely unexpected," said Dr. Dean A. Blumberg, associate professor of pediatric infectious diseases at the University of California, Davis.

"The field has not been entirely clear," Blumberg said. "We have been looking at different patient populations, of different ages, some with a large proportion of HIV-infected individuals. Some have different pathogens."

While the two trials were "exceptionally well done," the relatively small number of participants makes it more difficult to interpret the results, Blumberg said.

"Steroids might be allowing someone to live who might otherwise have died," he said. "I don't think this will affect guidelines here. In less developed areas, it may lead to a change in recommendations there."

More information

There's more on bacterial meningitis at the U.S. National Library of Medicine.



SOURCES: Matthew Scarborough, M.D., senior lecturer in infectious diseases, John Radcliffe Hospital, Oxford, England, and College of Medicine/Malawi-Liverpool-Wellcome Programme of Clincal Tropical Research, Blantyre, Malawi; Dean A. Blumberg, M.D., associate professor of pediatric infectious diseases, University of California, Davis; Dec. 13, 2007, New England Journal of Medicine


'/>"/>
Copyright©2007 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Steroids Seem Safe for Babies at Risk of Early Birth
2. Batters may achieve dramatic increases in home runs through steroids
3. Repeat steroids to premature infants linked to cerebral palsy
4. Multiple corticosteroid injections in pregnant women may increase cerebral palsy
5. International Law Enforcement Operation Targets Underground Manufacture of Anabolic Steroids
6. Steroids Are Abused for Skin, Not Just Muscles
7. Research Indicates Nearly 25 Percent of Supplements Are Contaminated With Steroids, Stimulants and Banned Substances
8. Federal research plan to determine nanotech risks fails to deliver
9. States HMO Report Card Fails in Meaningful Evaluation of Health Care Quality and Ignores Affordability
10. Emergency Care for Heart Attacks, Pneumonia Fails to Meet Goals
11. Experimental Drug Fails Against Heart Failure
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Steroid Fails to Ease Meningitis in Trials
(Date:5/27/2016)... ... May 27, 2016 , ... Each year ... complementary medicine. Allison Outerbridge is this year’s Life University winner of ... at the university’s Student Leadership Awards ceremony. , Outerbridge is approaching her last ...
(Date:5/26/2016)... ... 26, 2016 , ... W.S. Badger Co. Inc ., the maker of ... When Work Works Award for its use of effective workplace strategies to increase business ... project administered by the Families and Work Institute (FWI) and the Society for Human ...
(Date:5/26/2016)... ... May 26, 2016 , ... Connor Sports, ... as a partner for the Tamika Catchings Legacy Tour that will commemorate ... leader in hardwood basketball surfaces in all forms and levels of the game, Connor ...
(Date:5/26/2016)... ... May 26, 2016 , ... There are nearly 14.5 million ... million cancer survivors worldwide. On Sunday, June 5, 2016, communities around the world will ... Survivors Day®. , National Cancer Survivors Day® is an annual worldwide Celebration of ...
(Date:5/26/2016)... ... May 26, 2016 , ... An April Gallup survey found ... The 550 employees of Sun Health Senior Living (SHSL) may not share ... their doctor and prescription copays for the year, while holding the line on increasing ...
Breaking Medicine News(10 mins):
(Date:5/24/2016)... LONDON , May 24, 2016 ... erfüllt beide primären Endpunkte ... und Überlegenheit in ‚ausgezeichneter plus guter ... aufsteigenden Colons    ,      (Logo: ... B.V. gab heute neue positive Daten von der ...
(Date:5/24/2016)... Mass. , May 24, 2016  NxStage Medical, ... technology company focused on advancing renal care, today announced ... plans to participate in the following schedule of investor ... be made available at http://ir.nxstage.com/ . ... Jefferies Healthcare Conference NY, NY           Friday, June ...
(Date:5/24/2016)... HONG KONG , May 24, 2016 /PRNewswire/ ... primer stent de doble terapia del mundo, introduce ... fístula arteriovenosa. OrbusNeich, una compañía global ... cambian las vidas, ha expandido su cartera incluyendo ... catéteres balón JADE™ y Scoreflex™ PTA son los ...
Breaking Medicine Technology: