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Correspondence
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Volume 358:1399-1401 March 27, 2008 Number 13
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Corticosteroids for Bacterial Meningitis

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To the Editor: Mai et al. (Dec. 13 issue) report that dexamethasone improved survival among patients with definite bacterial meningitis.1 However, dexamethasone was associated with decreased survival in the group of patients with probable meningitis, which was hypothesized to be due to delayed antituberculosis treatment in patients with presumed tuberculous meningitis. Since it is recommended that corticosteroids be given before or at the time of the initial dose of antibiotics,2 do the authors recommend that only patients with positive Gram's staining of cerebrospinal fluid receive corticosteroids? Should this restriction be applied only to countries with a high incidence of tuberculous . . . [Full Text of this Article]



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