Dexamethasone is included in empiric meningitis therapy to reduce inflammatory complications.

• A. True
• B. False
• C. Not used
• D. Only for fungal meningitis

Answer: (A)

An important concept here is that dexamethasone is used as an adjunct in suspected bacterial meningitis to blunt the inflammatory response that occurs after antibiotic treatment begins. When bacteria are killed, their components trigger a cascade of inflammation that can cause brain edema, increased intracranial pressure, and damage to the auditory nerve. Dexamethasone helps dampen that response, reducing inflammatory complications and improving outcomes, particularly in pneumococcal meningitis and Hib meningitis in children. For best effect, it should be given just before or with the first dose of antibiotics and continued for about 2–4 days (adult dosing around 0.15 mg/kg every 6 hours). It is not used for fungal meningitis and is not typically beneficial in viral meningitis. Therefore, the statement is true.