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Dexamethasone for Children With Bacterial Meningitis:  Should It Be Routine Therapy?

SHELDON L. KAPLAN, MD
Am J Dis Child. 1989;143(3):290-292. doi:10.1001/archpedi.1989.02150150044014.
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Although most older infants and children develop normally after an episode of bacterial meningitis, some have subtle to moderate neurologic sequelae such as learning problems and speech delay, or suffer devastating neurologic injury. Although prevention of the disease is the optimal way to prevent neurologic damage due to bacterial meningitis, prompt and appropriate antimicrobial therapy and supportive care are the currently available means to limit or minimize neurologic sequelae. Newer antibiotics such as the third-generation cephalosporins have much greater in vitro activity against Haemophilus influenzae type b and are associated with greater bactericidal activity in cerebrospinal fluid than are ampicillin sodium or chloramphenicol sodium succinate. Therefore, it was hoped that the outcome of treatment with the newer agents would be superior to that following therapy with ampicillin or chloramphenicol. However, in all comparative trials to date, the outcome of children treated with the

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