Dexamethasone in Meningitis

Q: Dexamethasone is frequently used as an adjuvant therapy in bacterial meningitis. It should be given (select one)

A)  just before or simultaneously with the first dose of antibiotics
B)  after antibiotics are given


Answer: A

Due to not fully understood reasons, if dexamethasone is given after the administration of antibiotics in suspected bacterial meningitis, the likelihood of an unfavorable outcome is much higher. It can be avoided if antibiotics are already administered.


Reference:

van de Beek D, de Gans J, Spanjaard L, et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 2004; 351:1849.