标题：Meta-analysis of adjunctive dexamethasone to improve clinical outcome of bacterial meningitis in children
作者：Wang, Ying; Liu, Xinjie; Wang, Yuzhen; Liu, Qi; Kong, Cuicui; Xu, Guixia
作者机构：[Wang, Ying; Liu, Xinjie; Wang, Yuzhen] Shandong Univ, Qilu Hosp, Dept Pediat, 107 Wen Hua Xi Rd, Jinan 250012, Shandong, Peoples R China.; [Wang, Y 更多
通讯作者：Wang, Y;Wang, Y
通讯作者地址：[Wang, Y]Shandong Univ, Qilu Hosp, Dept Pediat, 107 Wen Hua Xi Rd, Jinan 250012, Shandong, Peoples R China;[Wang, Y]Peoples Hosp Zoucheng, 59 Qian Qua 更多
来源：CHILDS NERVOUS SYSTEM
关键词：Bacterial meningitis; Curative effect; Children; Dexamethasone;; Meta-analysis
摘要：Background The current recommended therapies for bacterial meningitis are effective antimicrobial agents and the implementation of childhood vaccination programs. However, the role of adjunctive dexamethasone therapy in bacterial meningitis remains controversial.; Methods Using meta-analysis, this study aims to investigate the efficacy of adjunctive dexamethasone therapy in bacterial meningitis by comparing it with antibiotic therapy. Documents of randomized controlled trials (RCT) related to the treatment of bacterial meningitis in children with dexamethasone published since the establishment of the databases to December in 2016 were retrieved from the databases of Cochrane Library, Pubmed, MEDLINE, EMBASE, Chinese BioMedical Literature Database, and China National Knowledge Infrastructure. The references in RCT were retrieved by hands at the same time. Full texts of screened documents were searched and given qualitative review, and then, all RCT included were analyzed statistically by using Review Manger 5.3 software.; Results The search yielded 15 studies (2409 children cases), among which 4 fall in grade A and 11 were grade B. The results of meta-analysis have shown that patients who received dexamethasone have significantly lower risks in incidence of hearing loss (OR = 0.68, 95% CI 0.53-0.89, P = 0.004) and severe neurological sequelae (OR = 0.59, 95% CI 0.37-0.95, P = 0.03), but the follow-up mortality is hardly effected (OR = 0.86, 95% CI 0.67-1.10, P = 0.23).; Conclusions Evidence has proven that the adjunctive administration of dexamethasone is conducive to treating children with bacterial meningitis to a certain extent, to decreasing the possibility of hearing loss and severe neurological sequelae, but has no significant effect on the follow-up mortality.