Corticosteroids for Acute Bacterial Meningitis in Developing Countries

Two studies conducted in resource-poor countries highlight the geographic, epidemiologic, and economic complexities in determining optimal treatment.

Mortality due to bacterial meningitis has decreased in the developed world with rapid diagnosis and treatment, including antibiotics and supportive care. In developing countries, however, mortality remains significantly higher. Recent studies have focused on reducing the inflammation and neurologic damage associated with bacterial lysis. Use of adjunctive corticosteroids has shown benefit in reducing mortality and morbidity for certain pathogens in developed countries, namely Streptococcus pneumoniae in adults and Haemophilus influenzae in children (N Engl J Med 2002; 347:1549 and JAMA 1997; 278:925). Two recent studies shed new light on potential benefits of adjunctive corticosteroids in developing countries.

Mai and colleagues conducted a …

Reviewing Author

Tracey A. Cho, MD