Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis

J Infect Dev Ctries. 2023 Dec 31;17(12):1748-1752. doi: 10.3855/jidc.18804.

Abstract

Introduction: There are no randomized controlled trials to inform the choice of using adjunctive dexamethasone (AD) against Listeria monocytogenes meningitis (LMM) and data from observational studies are pretty conflicting.

Methodology: We performed a rapid review of the literature with quantitative analysis. A pairwise random-effects meta-analysis was implemented, pooling unadjusted and adjusted data. The main outcome was mortality.

Results: Across all included studies (five) informing the main analysis on raw mortality data, 199 patients received AD, as opposed to 382 who did not receive AD. All-cause mortality was slightly lower in patients undergoing AD, but not in a statistically significant manner: odds ratio 0.96, 95% confidence interval 0.42-2.19. The prediction interval was very wide (0.06-15.99), suggesting that in future studies the effect of AD might be either beneficial or harmful.

Conclusions: The role of AD for LMM still needs to be established being the current evidence inconclusive and heterogeneous.

Keywords: dexamethasone; meta-analysis; neurolisteriosis; steroid; systematic review; therapy.

Publication types

  • Review
  • Meta-Analysis

MeSH terms

  • Causality
  • Dental Care
  • Dexamethasone / therapeutic use
  • Humans
  • Meningitis, Listeria* / diagnosis
  • Meningitis, Listeria* / drug therapy
  • Prognosis

Substances

  • Dexamethasone