[Value of dexamethasone therapy in bacterial meningitis]

Due to growing understanding of pathophysiological mechanisms in acute inflammation new strategies for treatment of bacterial meningitis have been developed. The use of dexamethasone as adjunctive therapy for bacterial meningitis during the first 4 days (0.15 mg per kilogram body weight every six hours 30 min before antibiotic treatment for four days) showed a significantly reduce of neurologic sequelae in four clinical studies. A reduction of case fatality rate in more severe cases down to 50% was observed. In regard of these results the American academy of infectious diseases recommends since 1991 for children from the age of 3 month with Haemophilus influenzae meningitis a therapy regime as above.