Dexamethasone is recommended as adjunctive therapy in bacterial meningitis, ideally administered before or with the first dose of antibiotics. The primary mechanism by which dexamethasone reduces neurological sequelae in this setting is:
- A Direct bactericidal synergy with beta-lactam antibiotics
- B Reduction of meningeal inflammation by inhibiting cytokine release and leukocyte infiltration ✓
- C Enhancement of blood-brain barrier permeability to antibiotics
- D Prevention of antibiotic-induced bacterial endotoxin release
Correct answer: B. Reduction of meningeal inflammation by inhibiting cytokine release and leukocyte infiltration
Explanation
Dexamethasone suppresses the intense inflammatory response in the subarachnoid space triggered by bacterial lysis from antibiotic action. By inhibiting cytokine release (TNF-alpha, IL-1) and leukocyte infiltration, it reduces cerebral edema and intracranial pressure, thereby decreasing the risk of hearing loss and neurological deficits. It must be given before or with antibiotics to be effective, as it cannot reverse damage already done.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.