Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Emergency Medicine

Answer 5
  1. Administration should occur before or with the first dose of antibiotics. Dexamethasone administered before or with the first dose of antibiotics improves outcomes in patients with acute bacterial meningitis. The recommended dose for adults is 10 mg intravenously every 6 hours for 4 days.9 This treatment plan does not increase the risk of gastrointestinal bleeding. Of note, dexamethasone decreases the blood-brain permeability, which could impede penetration of vancomycin into the subarachnoid space. Treatment failures have been noted in adults receiving vancomycin and dexamethasone. In children, treatment with dexamethasone did not reduce levels of vancomycin in cerebrospinal fluid.

9. deGans J, van de Beek D; European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators. Dexamethasone in adults with bacterial meningitis. N Eng J Med 2002;347:154956.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 2/25/08 • nvf