Current Infectious Disease Reports

, Volume 14, Issue 4, pp 445–453

Use of Corticosteroids and Other Adjunct Therapies for Acute Bacterial Meningitis in Adults

  • Kameshwar Prasad
  • Nirendra Kumar Rai
  • Amit Kumar
Central Nervous System and Eye Infections (KC Bloch, Section Editor)

DOI: 10.1007/s11908-012-0271-7

Cite this article as:
Prasad, K., Rai, N.K. & Kumar, A. Curr Infect Dis Rep (2012) 14: 445. doi:10.1007/s11908-012-0271-7

Abstract

Acute bacterial meningitis is associated with high morbidity and mortality despite the availability of effective antibiotics. The inflammatory response induced by bacterial products in the subarachnoid space is responsible for neuronal injury. The use of adjuvant therapy in acute bacterial meningitis draws its rationale from the notion of arresting the inflammatory cascade at an early stage of the disease to improve clinical outcome. Corticosteroids have been studied extensively in these patients and seems effective in selective groups of patients, particularly those with pneumococcal meningitis. Glycerol appears harmful in adults with acute bacterial meningitis. Experimental models suggest promising role of newer anti-inflammatory drugs such as antioxidants, inhibitors of Tumor Necrosis Factor-α, poly-ADP-ribose inhibitors, caspase inhibitors, brain-derived neurotrophic factor etc.; however clinical trials are still lacking for these novel potential targets in acute bacterial meningitis. This review focuses on corticosteroids with comments on the role of other potential adjuvant therapy in adults with acute bacterial meningitis.

Keywords

Acute bacterial meningitis Adjuvant therapy Corticosteroid Meningitis in adults Glycerol Tumor necrosis factor poly-ADP ribose Immunoglobulin Brain derived neurotrophic factor Intracranial pressure (ICP) monitoring Hypothermia 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Kameshwar Prasad
    • 1
  • Nirendra Kumar Rai
    • 2
  • Amit Kumar
    • 1
  1. 1.Department of NeurologyNeurosciences Centre, All India Institute of Medical SciencesAnsari NagarIndia
  2. 2.Asian Institute of Medical SciencesFaridabadIndia

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