King S M, Law B, Langley J M, Heurter H, Bremner D, Wang E E, Gold R
Division of Infectious Disease, Departments of Pediatrics and Audiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario; Division of Infectious Diseases, The Health Sciences Centre, Winnipeg, Manitoba; and Division of Infectious Diseases, The Izaak Walton Killam Hospital, Halifax, Nova Scotia.
Can J Infect Dis. 1994 Sep;5(5):210-5. doi: 10.1155/1994/257198.
A multicentre randomized controlled trial was conducted in children with bacterial meningitis using dexamethasone or placebo for four days within 24 h of starting antibiotics. Primary outcomes were hearing loss and neurological abnormalities at 12 months after meningitis. The dexamethasone (n=50) and placebo (n=51) groups were similar in age, severity of illness and etiological agent. Hearing loss occurred in 10% and 11% of the dexamethasone and placebo groups and neurological deficits occurred in 20% and 18% of patients, respectively. Duodenal perforation occurred in one dexamethasone-treated child. In conclusion, there was no significant benefit in those receiving dexamethasone. The lack of benefit may have been due to the delay in administration of dexamethasone (median delay of 11 h after antibiotics). Therefore, if dexamethasone is used for meningitis it should be given immediately with the antibiotic.
在患有细菌性脑膜炎的儿童中进行了一项多中心随机对照试验，在开始使用抗生素后的24小时内，使用地塞米松或安慰剂治疗四天。主要结局是脑膜炎后12个月时的听力丧失和神经功能异常。地塞米松组（n = 50）和安慰剂组（n = 51）在年龄、疾病严重程度和病原体方面相似。地塞米松组和安慰剂组分别有10%和11%的患者出现听力丧失，20%和18%的患者出现神经功能缺损。一名接受地塞米松治疗的儿童发生了十二指肠穿孔。总之，接受地塞米松治疗的患者没有显著获益。获益缺乏可能是由于地塞米松给药延迟（抗生素使用后中位延迟11小时）。因此，如果地塞米松用于治疗脑膜炎，应与抗生素同时立即给药。
