Prevention of auditory sequelae in pediatric bacterial meningitis: a meta-analysis

Meta-analysis methods were used to compare the effect of antibiotic regimens and corticosteroids on the development of auditory sequelae after pediatric bacterial meningitis. After a literature search of two major data bases, 11 studies met the criteria and were included in the analysis. Summary odds ratios, with 95% confidence intervals, were calculated that quantified the relative risk of developing auditory sequelae after specific therapies. No significant differences among antibiotics were identified in terms of reducing the risk of meningitis-related hearing impairment. However, corticosteroids significantly reduced the frequency of bilateral, moderate, or greater hearing loss. Patients receiving placebo versus dexamethasone were much more likely to develop auditory dysfunction (odds ratio 3.77; 95% CI 1.77-8.10). The results of this study add quantitative evidence supporting the use of dexamethasone as adjunctive therapy in pediatric bacterial meningitis.