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Although guidelines recommend routine use of adjunctive dexamethasone for adults with pneumococcal meningitis in high-income countries, clinical trials involving this practice have shown conflicting results, and the benefit remains unclear. Now, researchers have compared outcomes between adults (age, >16 years) in the Netherlands who received care for community-acquired pneumococcal meningitis between March 2006 and January 2009 (after implementation of these recommendations) and those who received such care between 1998 and 2002.
Using records from the Netherlands Reference Laboratory for Bacterial Meningitis, the researchers identified 352 eligible episodes of pneumococcal meningitis in 1998–2002 and 357 in 2006–2009. Clinical characterist…