ABSTRACT
Introduction Meningitis remains a disease that continues to cause significant morbidity and mortality in both industrialized and developing countries 11,21. For example, last year more than 21000 people suffered with meningitis in the African 'meningitis belt' and there were over 2300 deaths 131. There are between 1800 and 2500 cases of bacterial meningitis notified in England and Wales each year. Despite the availability of penicillin for 60 years, mortality rates remain high, at around 12%, for the common causes of bacterial meningitis. Death is often not due to the failure of antimicrobial therapy as such, but to the inflammatory consequences of infection. Over the years there has been great interest in the potential benefit of adjunctive treatments in bacterial meningitis. In the past 18 months there have been two major trials published investigating the role of treatment with steroids in children and adults with bacterial meningitis. They arrived at different conclusions, and underline the importance of applying the findings of research to the population from whom the conclusions were drawn.
