신생아 뇌막염에서 Dexamethasone의 치료효과

Abstract

Purpose : In experimental models of meningitis and in children with meningitis, dexametha-sone has been shown to reduce meningeal inflammation and to improve the outcome of disea-se. We studied the effects of dexamethasone administration in neonates(<2 month-old) with b-acterial meningitis. Methods : We retrospectively reviewed the medical records of 30 neonates admitted to the nursery, the Yonsei University College of Medicine who had findings characteristic of bacterial infection on examination of cerebrospinal fluid. Twenty neonates were received antibiotics only (grp I: n=20, Jan 1988-May 1991) and ten neonates were administered dexamethasone with a ntibiotics(grp II :n=10, Jun 1991-Jun 1993). Results : 1) The demographic, clinical, and laboratory profiles were similar for the patients in the two t reatment groups. 2) The mean increase in the cerebrospinal fluid concentration of glucose and the decrese in protein levels after 72 hours of therapy were significantly greater in grp II patients than Grp I (gl ucos 2.8 vs 20.8mg/dl, p<0.05). Secondary fever, defined as a rectal temperature 38.0℃ or m ore after at least 24 hours of maximal daily temperature of 37.9℃, occured more frequently in grp II (25% vs 70%, p<0.05). 3) Abnormal brain imaging studies were observed in more frequently in grp I (8/18, 44%) th an those in grp II (3/10, 30%). 4) There was no side effect of dexamethasone therapy. Conclusion : We conclude that dexamethasone is beneficial in the treatment of neonates with bacterial meningitis and is expected to prevent neurologic sequelae.