In adults with acute bacterial meningitis caused byStreptococcus pneumoniae, what are the effects of corticosteroids on morbidity and mortality?

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EVIDENCE-BASED ANSWERTreatment with corticosteroids decreases mortality by 16% in patients with acute S pneumoniae meningitis of any age (SOR: A, meta-analysis of RCTs), and corticosteroids decrease the odds of the combined outcome of death or severe-to-moderate disability at discharge in adults (SOR: B, cohort study). In adults and children with meningitis of any cause, corticosteroids lower the rates of neurological sequelae and hearing loss, but these effects appear to be restricted to some high-income countries and are not seen in low-income countries. (SOR: A, meta-analysis of RCTs).

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