Comparison of dexamethasone versus placebo for management of bacterial meningitis

Aim: to compare the efficacy of dexamethasone vs. placebo in decreasing in hospital mortality in addition to usual antibiotics for the management of patients presenting with bacterial meningitis. methods: this present randomized control trial was done in the department of medicine,mayo hospital,lahore. the non-probability purposive sampling technique was used in this study. informed consent was obtained from all patients. all patients were given a combination of cefotaxime in a dose of 2gramiv 8 hourly and vancomycin 1g iv 12 hourly. then patients were randomly divided in two groups by using lottery method. in group d,patients were given 10mg iv dexamethasone every six hoursfor four days and patients in group p not given dexamethasone with standard regimens.patients were followed during hospital stayfor mortality. data was stratified for age gender,duration of disease,tlc count at admission to deal with effect modifier. post stratification chi-square test was applied. p-value of <0.05 was considered significant. results: in this present study total 480 cases were enrolled. the mean age of the patients was 40.98±14.28 years. the male to female ratio of the patients was 2:1. in our study the mortality occurred in 55(11.5%) patients. statistically significant difference in mortality was observed between study group and placebo group. conclusion: our study results concluded that the dexamethasone is more effective in reducing the hospital mortality of bacterial meningitis patients as compared to placebo group.