The Use of Dexamethasone in Bacterial Meningitis in Children and Adults: A Retrospective Analysis

Table 1

Prognostic factors for unfavourable versus favourable outcome after 8 weeks.

	Unfavourable (𝑛=17)	Favourable (𝑛=49)	Odds ratio (95% CI)*
Age (yr)—mean ± SD	21 ± 30	20 ± 32	—
Males—%	65	51	—
Duration symptoms before admission (hr)—mean ± SD	45 ± 45	34 ± 41	—
Duration symptoms before admission <24 hrs—no./tot. no. (%)	10/17 (59)	36/48	0.48 (0.15–1.53)
Received dexamethasone—no./tot. no. (%)	11/17 (65)	33/49 (67)	0.89 (0.18–2.84)
Received AB in last 48 hr—no./tot. no. (%)	4/17 (24)	9/48 (19)	1.33 (0.35–5.06)
Coexisting conditions—no./tot. no. (%)
Otitis/sinusitis	2/17 (12)	15/49 (31)	0.30 (0.061–1.49)
Pneumoniae	3/17 (18)	4/49 (8)	2.41 (0.48–12.09)
Immunocompromise	4/17 (24)	3/49 (6)	4,72 (0,96–23,8)
Convulsions on admission—no./tot. no. (%)	7/17 (41)	6/49 (12)	5,0 (1,4–18,2)
Findings on admission—no./tot. no. (%)
Normal consciousness	2/17 (12)	31/49 (63)	0,07 (0,02–0,38)
GCS score < 8	4/10 (40)	2/40 (5)	12.67 (1.89–84.97)
Focal neurological signs	5/17 (29)	2/49 (4)	9,8 (1,69–56,8)
Temperature > 38°C	13/17 (76)	34/48 (71)	1.34 (0.37–44.82)
Triad (neck stiffness, fever, and altered mental status)	4/11 (36)	10/35 (28)	1.43 (0.34–5.97)
Petechiae	1/17 (6)	21/49 (43)	0,08 (0,01–0,68)
CSF culture—no./tot. no. (%)
S. pneumonia	12/17 (70)	15/49 (31)	5,44 (1,62–18,2)
N. meningitidis	3/17 (18)	17/49 (35)	0,4 (0,102–1,60)
Other bacteria	1/17 (6)	8/49 (16)	0.32 (0.037–2.77)
Negative culture	1/17 (6)	9/49 (18)	0.28 (0.032–2.37)
CSF parameters
Positive bacterial culture—no./tot. no. (%)	16/16 (100)	38/49 (78)	—
WBC (/mm^3)—mean ± SD	3401 ± 7211	6057 ± 8156	—
WBC < 1000/mm^3—no./tot. no. (%)	10/13 (77)	15/49 (31)	7,6 (1,82–31,4)
Proteins (mg/dL)—mean ± SD	558 ± 557	305 ± 263	—
Proteins > 500 mg/dL—no/tot no (%)	6/13 (46)	12/49 (24)	2,64 (0,74–9,39)
Glucose (mg/dL)—mean ± SD	18,5 ± 21,8	35,6 ± 25,1	—
Glucose < 20 mg/dL—no/tot no (%)	11/13 (85)	20/49 (41)	7,98 (1,59–39,9)
Glucose CSF/serum ratio (%)—mean ± SD	16 ± 14	28 ± 20	—
Lactate (mmol/L)—mean ± SD	12,3 ± 4,9	8,0 ± 5,0	—
Lactate > 10 mmol/L—no./tot. no. (%)	7/9 (78)	15/44 (34)	6,77 (1,25–36,7)
Positive blood culture, no./tot. no. (%)	9/16 (56)	22/48 (56)	1.52 (0.49–4.75)
Blood parameters
Hb** (g/dL)—mean ± SD	10,8 ± 2,4	12,0 ± 1,9	—
Platelets (×10^3/mm^3)—mean ± SD	269 ± 143	280 ± 148	—
CRP*** (mg/L)—mean ± SD	258 ± 119	176 ± 128	—
CRP > 200 mg/L—no./tot. no. (%)	12/17 (70)	19/49 (39)	3,78 (1,15–12,5)
Hyponatremia** in first 72u—no./tot. no. (%)	4/17 (24)	2/49 (4)	7,23 (1,19–43,9)
Referred from an other hospital—no./tot. no. (%)	10/17 (59)	9/49 (18)	6,35 (1,9–21,2)

*CI = confidence interval, **Hb = haemoglobin, ***CRP = C-reactive protein.