Journal of Neurology

, Volume 253, Issue 5, pp 570–573

Dexamethasone and prognostic factors in adults with bacterial meningitis

  • M. Weisfelt
  • D. van de Beek
  • R. J. de Haan
  • J. de Gans
ORIGINAL COMMUNICATION

Abstract

Objective

To determine the effect of dexamethasone on prognostic factors in adults with bacterial meningitis.

Design and setting

A post hoc multivariate analysis of the European Dexamethasone Study.

Patients and participants

Dexamethasone–treated patients in the European Dexamethasone Study. As internal validation we performed an identical analysis on patients in the placebo group.

Measurements and results

Only focal cerebral abnormalities on admission were predictive for unfavourable outcome in patients treated with early adjunctive dexamethasone (Odds ratio 3.22; 95% confidence interval 1.11–9.35; P=0.03). Other potential prognostic factors failed to achieve statistical significance. An analysis on patients in the placebo group showed prognostic factors comparable with those found in the literature without routine use of dexamethasone.

Conclusions

Routine use of dexamethasone therapy may lead towards new risk stratification in adults with bacterial meningitis.

Key words

bacterial meningitis dexamethasone prognosis multivariate analysis Streptococcus pneumoniae 

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References

  1. 1.
    van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB,Vermeulen M (2004) Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351:1849–1859PubMedCrossRefGoogle Scholar
  2. 2.
    de Gans J, van de Beek D (2002) Dexamethasone in adults with bacterial meningitis. N Engl J Med 347:1549–1556PubMedCrossRefGoogle Scholar
  3. 3.
    Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39:1267–1284PubMedCrossRefGoogle Scholar
  4. 4.
    van de Beek D, de Gans J (2004) Dexamethasone and pneumococcal meningitis. Ann Intern Med 141:327PubMedGoogle Scholar
  5. 5.
    Rothman KJ (2002) In: Epidemiology: an introduction.Oxford University Press New York, p 194Google Scholar

Copyright information

© Steinkopff-Verlag 2006

Authors and Affiliations

  • M. Weisfelt
    • 2
  • D. van de Beek
    • 2
  • R. J. de Haan
    • 1
  • J. de Gans
    • 2
  1. 1.Department of Clinical Epidemiology and BiostatisticsCentre of Infection and Immunity Amsterdam (CINIMA), Academic Medical CentreAmsterdamThe Netherlands
  2. 2.Department of NeurologyAcademic Medical CenterAmsterdamThe Netherlands

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