To analyze the pathogenic bacteria, feature of drug resistance and the efficacy of dexamethasone as the auxiliary medication in pediatric refractory purulent meningitis (PM). The 190 refractory PM child patients were selected for the culture of pathogenic bacteria and analysis of drug resistance. In total, 190 pathogenic bacteria were detected, consisting of gram-positive bacteria (77.37%). Of the gram-positive bacteria, the resistance rate of patients with staphylococcus epidermidis, streptococcus pneumoniae or Staphylococcus haemolyticus to levofloxacin was 100%, while in gram-negative bacteria, the resistance rate of patients with klebsiella pneumoniae to gentamycin was 100%. In the observation group, patients had a higher effectiveness rate. Besides, patients in the observation group recovered rapidly from the fever and anomalies in cerebral spine fluid and peripheral white blood cells, and the inflammation was greatly improved. However, difference in the incidence rates of adverse reactions of patients between two groups showed no statistical significance. Pediatric refractory PM involves the pathogenic bacteria, mainly including staphylococcus epidermidis and streptococcus pneumoniae, showing a high resistance to levofloxacin, while the auxiliary medication of dexamethasone can improve the efficacy, and inhibit the inflammation.