6/28/23, 10:13 PM European Dexamethasone Study Pathway Feedback Search Clinical Topics Home Studies European Dexamethasone Study European Dexamethasone Study Disease Acute bacterial meningitis Trial question What is the role of dexamethasone in adults with bacterial meningitis? Study design Multi-center Double blinded RCT Population Characteristics of study participants 44.0% female N = 301 56.0% male 301 patients (132 female, 169 male) Inclusion criteria: adults with bacterial meningitis Key exclusion criteria: history of hypersensitivity to -lactam antibiotics or corticosteroids; pregnancy; treatment with oral or parenteral antibiotics in the previous 48 hours, history of active tuberculosis or fungal infection, or a recent history of head trauma, neurosurgery, or peptic ulcer disease Interventions N=157 dexamethasone (10 mg administered 15 to 20 minutes before or with the first dose of antibiotic and was given every 6 hours for four days) N=144 placebo (matching placebo) Primary outcome Unfavorable outcome 25.0 % 25 https://web.pathway.md/studies/recQmBCmsHskx4Lld 1/2 6/28/23, 10:13 PM European Dexamethasone Study Pathway 18.8 % 15 12.5 % Significant decrease 6.3 % NNT = 10 0.0 % Dexamethasone Placebo Significant decrease in unfavorable outcome (15% vs. 25%; RR 0.59, 95% CI 0.37 to 0.94) Secondary outcomes Significant decrease in death (7% vs. 15%; RR 0.48, 95% CI 0.24 to 0.96) Significant decrease in unfavorable outcomes (26% vs. 52%; RR 0.5, 95% CI 0.3 to 0.83) Safety outcomes No significant differences in gastrointestinal bleeding (1% vs. 3%, p=0.27). Conclusion In adults with bacterial meningitis, dexamethasone was superior to placebo with respect to unfavorable outcome. Reference de Gans J, van de Beek D, European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators. Dexamethasone in adults with bacterial meningitis. N Engl J Med. 2002 Nov 14;347(20):1549-56. Open reference URL https://web.pathway.md/studies/recQmBCmsHskx4Lld 2/2