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A high proportion of patients with bacterial meningitis die or suffer severe neurological sequelae. A recent Cochrane systematic review concluded that adjunctive corticosteroids were well tolerated and reduced both mortality and neurological sequelae in adults, and severe hearing loss in children, with bacterial meningitis, particularly that caused by Streptococcus pneumoniae (Cochrane Database Syst Rev 2007; (1):CD004405). However, two randomized controlled trials of adjunct corticosteroid therapy were published subsequently, and neither found a benefit (JW Neurol Feb 26 2008). The trials were the largest studies conducted to date and were done in developing countries (Vietnam and Malawi).
Now, researchers have conducted a meta-analysis of …