The use of Dexamethasone in bacterial meningitis - USMLE Forums
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USMLE Step 2 CK Bits & Pieces High yield short focused points, monographs, charts, illustrations, tables, and other stuff related to the USMLE Step 2 CK Exam.


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  #1  
Old 06-12-2010
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Neuro The use of Dexamethasone in bacterial meningitis

A recent meta analysis published in March 2010 has found no statistically significant benefits of the adjunct administration of Dexamethasone in the treatment of bacterial meningitis.

Here's the link
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835871/

However, for the purposes of the CK exam It's perhaps still recommended. Such a debatable update will not make its ways to the boards so fast.

If you face a related question here's what you should rely on in answering:

Dexamethasone is recommended in the treatment of bacterial meningitis. The greatest benefit is observed when it's given concomitantly with the first antibiotic dose. This is because the bacterial killing and lysis by the antibiotics will cause an intense inflammatory reaction in the meninges that may contribute to the observed meningitis mortality and morbidity.
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Old 06-12-2010
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This is an interesting read, I have'nt checked it out yet but will do soon after this UFC PPV event is over.

It does make sense guys and gals. If you have a bacterial/viral/fungal merningitis that is much too extensive and spread througout the body, the use of Steroids (of course AFTER adequate antibiotic therapy) doesn't seem too crazy. The Steroids shooouuullld prevent inflammation, therefore future scarring of the arachnoid villi in a CSF flow system, preventing a future nonobstructive Hydrocephalus.

So basically, once the bugs are killed with antibioitics, steroid that patient up! Why not? Only for a while anyway. Intermittent dosage, whatever works...
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