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Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...

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Updated: Jul 17, 2026

Inducing Meningococcal Meningitis Serogroup C in Mice via Intracisternal Delivery

Inducing Meningococcal Meningitis Serogroup C in Mice via Intracisternal Delivery

Published on: November 5, 2019

Corticosteroids for acute bacterial meningitis.

D van de Beek¹, J de Gans, P McIntyre

¹Academic Medical Center University of Amsterdam, Department of Neurology, Center for Infection and Immunity Amsterdam (CINIMA), P.O. Box 22700, 1100 DE, Amsterdam, Netherlands. D.vandeBeek@amc.uva.nl

The Cochrane Database of Systematic Reviews

|January 27, 2007

Summary

Adjuvant corticosteroids significantly reduce mortality and severe hearing loss in bacterial meningitis. While beneficial for adults and children in high-income countries, no benefit was observed for children in low-income settings.

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Last Updated: Jul 17, 2026

Inducing Meningococcal Meningitis Serogroup C in Mice via Intracisternal Delivery

Inducing Meningococcal Meningitis Serogroup C in Mice via Intracisternal Delivery

Published on: November 5, 2019

Area of Science:

Neurology
Infectious Diseases
Pharmacology

Background:

Acute bacterial meningitis involves severe inflammation in the subarachnoidal space, impacting clinical outcomes.
Corticosteroid treatment can mitigate this inflammatory response, potentially improving patient outcomes.

Purpose of the Study:

To systematically review the efficacy and safety of adjuvant corticosteroid therapy in acute bacterial meningitis.
To analyze the impact of corticosteroids on mortality, hearing loss, and neurological sequelae.

Main Methods:

A meta-analysis of randomized controlled trials (RCTs) was conducted.
Searches included major databases (MEDLINE, EMBASE, CENTRAL) and contact with researchers.
Data extraction and quality assessment were performed independently by two reviewers.

Main Results:

Corticosteroids reduced overall case fatality (RR 0.83) and severe hearing loss (RR 0.65).
In adults, corticosteroids significantly decreased death (RR 0.57) and short-term neurological sequelae (RR 0.42).
In children, severe hearing loss was reduced (RR 0.61), particularly with Haemophilus influenzae meningitis (RR 0.37).

Conclusions:

Adjuvant corticosteroids significantly improve outcomes in acute bacterial meningitis by reducing mortality, severe hearing loss, and neurological sequelae.
Corticosteroid therapy should be given with the first antibiotic dose in adults.
Adjunctive corticosteroids are supported for children in high-income countries, but not in low-income countries.