Which adjunctive therapy is commonly given in bacterial meningitis to reduce inflammatory complications?

• A. Acetaminophen
• B. Epinephrine
• C. No adjunct
• D. Dexamethasone

Answer: (D)

Bacterial meningitis triggers a strong inflammatory response in the subarachnoid space, and this inflammation can cause brain edema, vasculitis, and sensorineural damage. Giving a corticosteroid as an adjunct—specifically dexamethasone—blunts that inflammatory cascade when given just before or with the first dose of antibiotics. By dampening cytokine release and meningeal inflammation, dexamethasone lowers the risk of complications such as hearing loss in children and reduces mortality and neurologic sequelae in adults with pneumococcal meningitis. Other options don’t target this inflammatory injury the same way—acetaminophen can reduce fever but doesn’t lessen inflammatory damage to the CNS; epinephrine isn’t used for this purpose; and not using any adjunct misses the opportunity to mitigate inflammatory complications.