Steroids provide no survival benefit for children with bacterial meningitis

Meningitis is an inflammation of the meninges, the membrane lining the brain. The bacterial form is relatively rare in children, with an incidence of about eight in 100,000 in the U.S. However, bacterial meningitis is potentially life-threatening, and requires hospitalization and treatment with antibiotics. Several different varieties of bacteria may cause meningitis, although the patterns have changed with the introduction of vaccines.

Previous studies had shown that corticosteroids had a clear benefit in preventing hearing loss in children whose meningitis was caused by Hemophilus influenzae type b (Hib) bacteria. However, since the Hib vaccine was approved for routine use in childhood immunizations in 1985, cases of Hib meningitis have dropped sharply in the United States. Now bacterial meningitis in children is more commonly caused by pneumococcal or meningococcal bacteria.

Further studies may reveal that corticosteroids may also reduce hearing loss or other neurologic injuries in children with bacterial meningitis not caused by Hib, said Shah, but there is currently no such evidence. He added, “Our study shows the need for a further study in children—a large randomized clinical trial to examine all outcomes of steroid use, before the use of these medicines becomes routine in children with bacterial meningitis.”

The National Center for Research Resources, part of the National Institutes of Health, supported the study, along with the Agency for Healthcare Research and Quality. One co-author, Jillian Mongelluzzo, B.A., received support from the Doris Duke Medical Student Clinical Research Fellowship. Shah’s other co-authors were Zeinab Mohamad, M.S., from Children’s Hospital, and Thomas R. Ten Have, Ph.D., from the University of Pennsylvania School of Medicine.

About The Children’s Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.