In suspected bacterial meningitis, which adjunctive therapy is often given to reduce neurologic complications when antibiotics are started?

• A. Acyclovir
• B. Interferon
• C. Immunoglobulin therapy
• D. Dexamethasone with first dose of antibiotics

Answer: (D)

When treating suspected bacterial meningitis, the goal is to limit the inflammatory damage that occurs after antibiotics start. Giving dexamethasone, a corticosteroid, just before or with the first dose of antibiotics dampens the immune response in the meninges. This lowers the release of inflammatory mediators and reduces brain swelling and injury, which helps prevent neurologic complications such as deafness and seizures. The benefit is strongest for Hib meningitis in children and pneumococcal meningitis in adults, and timing is key—dexa should be given with the first antibiotic dose and continued for a short course (about 2–4 days). The other options don’t target this early inflammatory cascade in the meninges, so they don’t provide the same protective effect in this scenario.