Beneficial effects of dexamethasone in children with pneumococcal meningitis
| Autor: | Mehmet Ceyhan, Güler Kanra, Erol Belgin, Gülten Seçmeer, Hasan Özen, Ecevit Z |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Adolescent medicine.drug_class Hearing loss Placebo Dexamethasone Double-Blind Method medicine Humans Prospective Studies Child Prospective cohort study medicine.diagnostic_test Meningitis Pneumococcal business.industry Glasgow Coma Scale Prognosis medicine.disease Anti-Bacterial Agents Surgery Survival Rate Infectious Diseases Child Preschool Anesthesia Pediatrics Perinatology and Child Health Corticosteroid Drug Therapy Combination Female Pure tone audiometry medicine.symptom business Meningitis Follow-Up Studies medicine.drug |
| Zdroj: | The Pediatric Infectious Disease Journal. 14:490-494 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/00006454-199506000-00005 |
| Popis: | Fifty-six children older than 2 years with meningitis caused by Streptococcus pneumoniae were enrolled in a prospective, double blind, placebo-controlled trial to evaluate the efficacy of dexamethasone therapy in addition to antimicrobial therapy. Twenty-nine of 56 received dexamethasone (0.6 mg/kg/day iv, divided into 4 daily doses for 4 days) and the remaining 27 received placebo. At the beginning of therapy the clinical and laboratory characteristics of the patients in the treatment groups were comparable, except for the Glasgow coma score (P = 0.004), which was lower in the dexamethasone group. Patients were examined daily during hospitalization and 6 weeks after discharge from the hospital. Hearing was assessed 6 weeks after discharge by means of pure tone audiometry. Two patients in the dexamethasone group and one patient in the placebo group died. There were no differences between the two groups with regard to the duration of fever, the incidence of secondary fever and electrolyte imbalance, seizure activities occurring during hospitalization and rash. Although the differences were statistically insignificant, moderate or severe unilateral or bilateral sensorineural hearing loss at 6 weeks and the overall neurologic sequelae, including hearing loss, at 1 year were higher in the placebo group, at 23% vs. 7.4% (P = 0.11) and 26.9% vs. 7.4% (P = 0.062), respectively. At 3 months after discharge, because of the improvement in hearing loss in one dexamethasone-treated patient the incidence of hearing impairment was significantly less than that in the placebo group, at 3.7% vs. 23%, respectively (P = 0.044). No improvement in hearing loss was observed after 3 months.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|