Limited efficacy of adjuvant therapy with dexamethasone in preventing hearing loss due to experimental pneumococcal meningitis in the infant rat. Pediatr Res 2007

ABSTRACT: Sensorineural hearing loss (SNHL) is the most com-mon sequel of bacterial meningitis (BM) and is observed in up to 30 % of survivors when the disease is caused by Streptococcus pneumoniae. BM is the single most important origin of acquired SNHL in childhood. Anti-inflammatory dexamethasone holds prom-ises as potential adjuvant therapy to prevent SNHL associated with BM. However, in infant rats, pneumococcal meningitis (PM) in-creased auditory brainstem response (ABR) thresholds [mean differ-ence 54 decibels sound pressure level (dB SPL)], measured 3 wk after infection, irrespective to treatment with ceftriaxone plus dexa-methasone or ceftriaxone plus saline (p 0.005 compared with mock-infected controls). Moreover, dexamethasone did not attenuate short- and long-term histomorphologic correlates of SNHL. At 24 h after infection, blood-labyrinth barrier (BLB) permeability was sig-nificantly increased in infected animals of both treatment group