Current Infectious Disease Reports

, Volume 7, Issue 4, pp 285–291

Adjunctive corticosteroids in adults with bacterial meningitis

  • Diederik van de Beek
  • Jan de Gans


Bacterial meningitis is a complex disorder in which neurologic injury is caused, in part, by the causative organism and, in part, by the host’s own inflammatory response. In studies of experimental bacterial meningitis, adjuvant treatment with corticosteroids, specifically dexamethasone, has beneficial effects. On the basis of these experimental studies, several clinical trials were undertaken to determine the effects of adjunctive corticosteroids in patients with bacterial meningitis. On the basis of overall benefit without detrimental effects by subgroup analysis, dexamethasone therapy should be initiated before or with the first dose of antibiotic and should be continued in most patients with community-acquired acute bacterial meningitis. For patients with a low suspicion of meningitis but an urgent need for antibiotics before cerebrospinal fluid can be obtained, we recommend initiation of treatment with dexamethasone, with discontinuation of dexamethasone therapy as soon as the diagnosis has been excluded.


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Copyright information

© Current Science Inc. 2005

Authors and Affiliations

  • Diederik van de Beek
    • 1
  • Jan de Gans
  1. 1.Department of Neurology, Academic Medical CenterUniversity of AmsterdamDE, AmsterdamThe Netherlands

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