Steroid Fails to Ease Meningitis...(severe complications between those who g...),Health

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."

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