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Steroids Provide No Survival Benefit for Children With Bacterial Meningitis
Date:5/6/2008

ignificant difference in those outcomes between those receiving and not receiving corticosteroids in the subsets of children with meningitis caused by pneumococcal bacteria or by meningococcal bacteria.

Meningitis is an inflammation of the meninges, the membrane lining the brain. The bacterial form is relatively rare in children, with an incidence of about eight in 100,000 in the U.S. However, bacterial meningitis is potentially life-threatening, and requires hospitalization and treatment with antibiotics. Several different varieties of bacteria may cause meningitis, although the patterns have changed with the introduction of vaccines.

Previous studies had shown that corticosteroids had a clear benefit in preventing hearing loss in children whose meningitis was caused by Hemophilus influenzae type b (Hib) bacteria. However, since the Hib vaccine was approved for routine use in childhood immunizations in 1985, cases of Hib meningitis have dropped sharply in the United States. Now bacterial meningitis in children is more commonly caused by pneumococcal or meningococcal bacteria.

Further studies may reveal that corticosteroids may also reduce hearing loss or other neurologic injuries in children with bacterial meningitis not caused by Hib, said Shah, but there is currently no such evidence. He added, "Our study shows the need for a further study in children -- a large randomized clinical trial to examine all outcomes of steroid use, before the use of these medicines becomes routine in children with bacterial meningitis."

The National Center for Research Resources, part of the National Institutes of Health, supported the study, along with the Agency for Healthcare Research and Quality. One co-author, Jillian Mongelluzzo, received support from the Doris Duke Medical Student Clinical Research Fellowship. Shah's other co-authors were Zeinab Mohamad, M.S., from Children's Hospital, and Thomas R. Ten Have, Ph.D., from the University of Pen
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SOURCE The Children's Hospital of Philadelphia
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