Daoud A S, Batieha A, Al-Sheyyab M, Abuekteish F, Obeidat A, Mahafza T
Department of Pediatrics, Jordan University of Science & Technology, Faculty of Medicine, Irbid.
Eur J Pediatr. 1999 Mar;158(3):230-3. doi: 10.1007/s004310051056.
A clinical trial was conducted to determine whether dexamethasone as adjunctive therapy alters the outcome of bacterial meningitis in neonates. Fifty-two full-term neonates with bacterial meningitis were enrolled in a prospective study. Infants were alternately assigned to receive either dexamethasone or not. Twenty-seven received dexamethasone in addition to standard antibiotic treatment and 25 received antibiotics alone. Dexamethasone therapy was started 10-15 min before the first dose of antibiotics in a dose of 0.15 mg/kg per 6 h for 4 days. Baseline characteristics, clinical and laboratory features in the two groups were virtually similar. Both groups showed a similar clinical response and similar frequency of mortality and sequelae. Six (22%) babies in the treatment group died compared to 7 (28%) in the control group (P = 0.87). At follow up examinations up to the age of 2 years, 6 (30%) of dexamethasone recipients and 7 (39%) of the control group had mild or moderate/severe neurological sequelae. Audiological sequelae were seen in two neonates in the dexamethasone group compared to one in the control group.
Adjunctive dexamethasone therapy does not improve the outcome of neonatal bacterial meningitis.
进行了一项临床试验，以确定地塞米松作为辅助治疗是否会改变新生儿细菌性脑膜炎的预后。52例足月细菌性脑膜炎新生儿纳入一项前瞻性研究。婴儿被交替分配接受地塞米松或不接受地塞米松治疗。27例在标准抗生素治疗基础上加用地塞米松，25例仅接受抗生素治疗。地塞米松治疗在首剂抗生素前10 - 15分钟开始，剂量为每6小时0.15mg/kg，共4天。两组的基线特征、临床和实验室特征基本相似。两组的临床反应、死亡率和后遗症发生率相似。治疗组6例（22%）婴儿死亡，对照组7例（28%）（P = 0.87）。在随访至2岁时，地塞米松治疗组6例（30%）有轻度或中度/重度神经后遗症，对照组7例（39%）有此类情况。地塞米松组2例新生儿有听力后遗症，对照组1例有听力后遗症。
辅助地塞米松治疗不能改善新生儿细菌性脑膜炎的预后。
