Corticosteroids for Everyone with Meningitis?

In 1988, a landmark study was reported on the use of adjunctive treatment with dexamethasone in infants and children who had bacterial meningitis.1 The rationale for this study was based on studies involving animal models of bacterial meningitis, which demonstrated that the subarachnoid-space inflammatory response was a major factor contributing to morbidity and mortality among patients with this disorder. This inflammatory response is generated through local release by the central nervous system of proinflammatory mediators such as interleukin-1 and tumor necrosis factor in response to lysis of meningeal pathogens induced by antimicrobial agents. The consequences of this inflammatory response were . . .