{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T08:48:51Z","timestamp":1772527731005,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Despite advances in antimicrobial treatment of bacterial meningitis in children, morbidity and mortality are substantial. Adjuvant dexamethasone is currently recommended for children with meningitis due to Haemophilus influenzae type b to improve outcome; recommendations for use of dexamethasone in children with meningitis due to Streptococcus pneumoniae are controversial. Conclusions regarding dexamethasone use for children with pneumococcal meningitis are derived from existing meta-analyses, which are confounded by the inclusion of studies with small numbers, substantial economic variability, and poor design. In contrast, circumstantial data derived from adult studies of pneumococcal meningitis are compelling in demonstrating effectiveness of dexamethasone in improving mortality and neurologic outcomes. Barring known differences in the inflammatory response stimulated by S pneumoniae according to age or the impact of steroids on inflammation according to age, this review endorses dexamethasone for children with pneumococcal meningitis.<\/jats:p>","DOI":"10.1093\/ofid\/ofaf456","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T12:09:07Z","timestamp":1754050147000},"source":"Crossref","is-referenced-by-count":1,"title":["Dexamethasone as Adjuvant Therapy for Bacterial Meningitis in Children: What About <i>Streptococcus pneumoniae<\/i>?"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9305-8532","authenticated-orcid":false,"given":"Ellen R","family":"Wald","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"2025082601265357500_ofaf456-B1","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/WCO.0000000000000934","article-title":"Acute bacterial meningitis","volume":"34","author":"Wall","year":"2021","journal-title":"Curr Opin Neurol"},{"key":"2025082601265357500_ofaf456-B2","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1093\/cid\/civ368","article-title":"Impact of the 13-valent pneumococcal conjugate vaccine on pneumococcal meningitis in US children","volume":"61","author":"Olarte","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2025082601265357500_ofaf456-B3","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1128\/CMR.00008-11","article-title":"Pathogenesis and pathophysiology of pneumococcal meningitis","volume":"24","author":"Mook-Kanamori","year":"2011","journal-title":"Clin Microbiol Rev"},{"key":"2025082601265357500_ofaf456-B4","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1056\/NEJM199505113321907","article-title":"Pathogenesis of pneumococcal infection","volume":"332","author":"Tuomanen","year":"1995","journal-title":"N Engl J Med"},{"key":"2025082601265357500_ofaf456-B5","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/S0022-3476(05)82647-2","article-title":"Molecular pathophysiology of bacterial meningitis: current concepts and therapeutic implications","volume":"116","author":"Saez-Llorens","year":"1990","journal-title":"J Pediatr"},{"key":"2025082601265357500_ofaf456-B6","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1007\/BF02013304","article-title":"Induction of meningeal inflammation by diverse bacterial cell walls","volume":"5","author":"Tuomanen","year":"1986","journal-title":"Eur J Clin Microbiol"},{"issue":"2","key":"2025082601265357500_ofaf456-B7","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1093\/infdis\/155.2.213","article-title":"Dexamethasone in the treatment of experimental \u00a0Haemophilus influenzae type b meningitis","volume":"155","author":"Syrogiannopoulos","year":"1987","journal-title":"J Infect Dis"},{"key":"2025082601265357500_ofaf456-B8","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1097\/00006454-198912000-00037","article-title":"Role of tumor necrosis factor alpha (cachectin) in experimental and clinical bacterial meningitis","volume":"8","author":"Mustafa","year":"1989","journal-title":"Pediatr Infect Dis J"},{"key":"2025082601265357500_ofaf456-B9","first-page":"CD010435","article-title":"Adjuvant corticosteroids for reducing death in neonatal bacterial meningitis","volume":"2015","author":"Ogunlesi","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082601265357500_ofaf456-B10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.mce.2010.04.005","article-title":"The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights","volume":"335","author":"Coutinho","year":"2011","journal-title":"Mol Cell Endocrinol"},{"key":"2025082601265357500_ofaf456-B11","first-page":"336","article-title":"The use of intravenous hydrocortisone as supplemental treatment in acute bacterial meningitis; an alternate case study","volume":"5","author":"Lepper","year":"1957","journal-title":"Antibiot Annu"},{"key":"2025082601265357500_ofaf456-B12","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1542\/peds.44.1.30","article-title":"Corticosteroids as an adjunct to treatment in bacterial meningitis. 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