The effectiveness of dexamethasone in the management of acute pyogenic bacterial meningitis
Acute bacterial meningitis is associated with significant morbidity and mortality rates despite the advances in antimicrobial therapy. Adjunctive corticosteroid therapy for acute bacterial meningitis is one of the most widely discussed controversial issues recently. Thus, the aim of this review is to evaluate the effectiveness of dexamethasone as an adjunctive treatment to improve the clinical outcome and prevent complications in acute bacterial meningitis patients. Dexamethasone is classified as glucocorticoid agonist; mostly indicated as an anti-inflammatory medication used specifically to decrease cerebral edema. Although many studies have supported the beneficial effect of adjuvant dexamethasone in preventing cerebral edema in acute bacterial meningitis, it has been reported that dexamethasone has major side effects and no significant evident effect in lowering mortality rates. In addition, it has a marked effect on limiting the penetration of antibiotics into the cerebrospinal fluid. All these results support the stance against using dexamethasone in acute bacterial meningitis.