Betamethasone and dexamethasone in adult community-acquired bacterial meningitis : a quality registry study from 1995 to 2014

Abstract Acute bacterial meningitis (ABM) is a highly lethal disease. Available data support the use of corticosteroids in high-income countries, but the effect on mortality is still controversial. The effects of corticosteroids on mortality and sequelae were evaluated in the national Swedish quality registry. In total, during 1995–2014 1746 adults with ABM were included, of whom 989 were treated with corticosteroids (betamethasone, n  = 766; dexamethasone, n  = 248; methylprednisolone, n  = 2), 498 were not given corticosteroids and in 259 patients data for corticosteroids were missing. Fatal outcome was observed in 8.9% of the patients in the corticosteroid-treated group vs. 17.9% in the non-corticosteroid-treated group ( p S. pneumoniae , mortality was 10.2% in the corticosteroid-treated group and 21.3% in the non-corticosteroid-treated group ( p