Dexamethasone and prognostic factors in adults with bacterial meningitis

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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.

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