Lack of effectiveness of dexamethasone in neonatal bacterial meningitis

Eur J Pediatr. 1999 Mar;158(3):230-3. doi: 10.1007/s004310051056.


A clinical trial was conducted to determine whether dexamethasone as adjunctive therapy alters the outcome of bacterial meningitis in neonates. Fifty-two full-term neonates with bacterial meningitis were enrolled in a prospective study. Infants were alternately assigned to receive either dexamethasone or not. Twenty-seven received dexamethasone in addition to standard antibiotic treatment and 25 received antibiotics alone. Dexamethasone therapy was started 10-15 min before the first dose of antibiotics in a dose of 0.15 mg/kg per 6 h for 4 days. Baseline characteristics, clinical and laboratory features in the two groups were virtually similar. Both groups showed a similar clinical response and similar frequency of mortality and sequelae. Six (22%) babies in the treatment group died compared to 7 (28%) in the control group (P = 0.87). At follow up examinations up to the age of 2 years, 6 (30%) of dexamethasone recipients and 7 (39%) of the control group had mild or moderate/severe neurological sequelae. Audiological sequelae were seen in two neonates in the dexamethasone group compared to one in the control group.

Conclusion: Adjunctive dexamethasone therapy does not improve the outcome of neonatal bacterial meningitis.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use*
  • Drug Therapy, Combination / therapeutic use
  • Follow-Up Studies
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use*
  • Humans
  • Infant, Newborn
  • Meningitis, Bacterial / drug therapy*
  • Prospective Studies
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Glucocorticoids
  • Dexamethasone