Dexamethasone and Pneumococcal Meningitis

Letters17 August 2004Dexamethasone and Pneumococcal MeningitisDiederik van de Beek, MD, PhD and Jan de Gans, PhDDiederik van de Beek, MD, PhDFrom Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, the Netherlands. and Jan de Gans, PhDFrom Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-4-200408170-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Dexamethasone reduces mortality rates in adults with pneumococcal meningitis (1).Objective: We wanted to determine whether the beneficial effect of dexamethasone on mortality rates in adults with pneumococcal meningitis is attributable to beneficial effects on neurologic or systemic complications.Methods and Findings: We did a post hoc analysis of the European Dexamethasone in Adulthood Bacterial Meningitis Study (1). We included patients who had pneumococcal meningitis proven by cerebrospinal fluid culture. Deaths within 14 days after admission were categorized; we chose a survival point of 14 days because deaths within this period were probably directly related to ...References1. de Gans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med. 2002;347:1549-56. [PMID: 12432041] CrossrefMedlineGoogle Scholar2. McMillan DA, Lin CY, Aronin SI, Quagliarello VJ. Community-acquired bacterial meningitis in adults: categorization of causes and timing of death. Clin Infect Dis. 2001;33:969-75. [PMID: 11528567] CrossrefMedlineGoogle Scholar3. Annane D, Sebille V, Charpentier C, Bollaert PE, Francois B, Korach JM, et al . Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288:862-71. [PMID: 12186604] CrossrefMedlineGoogle Scholar4. Annane D, Bellissant E, Bollaert PE, Briegel J, Keh D, Kupfer Y. Corticosteroids for treating severe sepsis and septic shock. Cochrane Database Syst Rev. 2004;:CD002243. [PMID: 14973984] MedlineGoogle Scholar5. Cooper MS, Stewart PM. Corticosteroid insufficiency in acutely ill patients. N Engl J Med. 2003;348:727-34. [PMID: 12594318] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Diederik van de Beek, MD, PhD; Jan de Gans, PhDAffiliations: From Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, the Netherlands. 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