A trial of steroids and intra-muscular injection of antibiotics in adults with bacterial meningitis
Research archive
- University of Malawi, Blantyre, Malawi, Liverpool School of Tropical Medicine, Liverpool, UK
- Project Number: 0009.0
- Category: Treatment
- Duration: 2001-2005
- Start Date: 01 January 2001
- Type: Lay summary
- View scientific version
Steroid therapy could be a major advance in treating bacterial meningitis, but research is needed to show if it works.
Brain damage from meningitis is actually caused by the body's natural response to bacterial toxins: inflammation. By relieving inflammation, steroids could reduce damage and improve chances of survival. We already know this treatment works in children with certain types of meningitis. This project will be the first study large enough to answer this question for adult meningitis patients.
Malawi is a country with rampant pneumococcal meningitis with particularly bad prognosis because of the lack of treatment available.
Part one of this project will test the effectiveness of steroids for treating meningitis, by comparing the outcome for meningitis patients treated with both steroids and antibiotics with the outcome for patients who receive antibiotics alone. All patients will be carefully monitored to ascertain whether steroids in this setting are both safe and effective.
In the second part of this project, doctors will find out whether intra-muscular antibiotic injection works. The most basic and vital element in treating meningitis, is to give effective antibiotics as quickly as possible. Recently, ceftriaxone, the antibiotic of choice in industrialised countries, has become affordable in Africa. In the West it is administered intra-venously, but in Malawi, this is only possible in large hospitals which most people can't get to, so it is not practical. Intra-muscular injection of ceftriaxone, if effective, would require less expertise, and be feasible in local hospitals, enabling earlier treatment. Results from this part of the project could save many lives throughout the African continent, while the first part of the project could lead to new recommendations in meningitis treatment worldwide.
Read our news release on this project:
Researchers in Liverpool conduct steroid trials to combat meningitis in Africa
Results from this study have been published in a scientific journal as follows:
Scarborough M, Njalale Y,
Bacterial meningitis in a high HIV prevalence setting in sub-Saharan Africa--challenges to a better outcome
Trop Doct 2004 Oct;34(4):203-5.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15510942&query_hl=13&itool=pubmed_docsum