Studies have demonstrated that patients with pneumococcal meningitis had reduced mortality (14 versus 34 percent placebo) and hearing loss (ototoxicity) when dexamethasone was given shortly before (~20mins) or concurrently with first dose antimicrobial therapy.
Dosed: Dexa 10mg IV 20mins prior or same time before first dose q6hrs x4 days.
NOTE: Patients who did not have pneumococcal meningitis (i.e meningococcal meningitis) had significantly lower rates of mortality (4 vs. 9 percent placebo), regardless of dexamethasone therapy. Also, patients are unlikely to benefit from steroids if they are started AFTER initiation of antimicrobial therapy.
REFERENCES
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