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Volume 348:954-957 March 6, 2003 Number 10
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Dexamethasone in Adults with Bacterial Meningitis

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by Tunkel, A. R.
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by de Gans, J.
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To the Editor: The study by de Gans and van de Beek and their colleagues (Nov. 14 issue)1 demonstrates the benefits of dexamethasone in adults with bacterial meningitis. The authors conclude by recommending dexamethasone for all adults with acute bacterial meningitis. How to operationalize this recommendation poses a problem. In addition to having suspected meningitis, patients in this study had to have cloudy cerebrospinal fluid, bacteria on Gram's staining, or a cerebrospinal fluid white-cell count of more than 1000. Thus, these patients were very likely to have acute bacterial meningitis. Most patients seeking medical attention with suspected meningitis, however, are . . . [Full Text of this Article]



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