Table 1. Baseline Characteristics of the Patients.*.
| Characteristic | Corticosteroid (N = 233) | Placebo (N = 232) | Intramuscular Ceftriaxone (N = 230) | Intravenous Ceftriaxone (N= 235) |
|---|---|---|---|---|
| Age — yr | 32.3±10.1 | 32.6±11.4 | 32.4±10.9 | 32.6±10.6 |
| Male sex — no. (%) | 122 (52) | 108 (47) | 115 (50) | 115 (49) |
| Glasgow Coma Scale score† | 10.7±3.5 | 10.8±3.3 | 11±3.4 | 10.4±3.4 |
| Hemoglobin — g/dl | 10.4±2.8 | 10.7±3.1 | 10.5±3.0 | 10.7±2.8 |
| Median time to presentation — hr (interquartile range) | 72 (48–120) | 72 (48–144) | 72 (48–144) | 72 (48–120) |
| Previous treatment with antimicrobial agents — no. (%)‡ | ||||
| Oral | 35 (15) | 42 (18) | 34 (15) | 43 (18) |
| Parenteral | 48 (21) | 47 (20) | 49 (21) | 46 (20) |
| Not known | 4 (2) | 8 (3) | 6 (3) | 6 (3) |
| Microbiologic diagnosis — no. (%) | ||||
| Proven bacterial | 158 (68) | 167 (72) | 155 (67) | 170 (72) |
| Streptococcus pneumoniae | 130 (56) | 145 (62) | 131 (57) | 144 (61) |
| Neisseria meningitidis | 10 (4) | 10 (4) | 13 (6) | 7 (3) |
| Other gram-negative organisms§ | 15 (6) | 10 (4) | 9 (4) | 16 (7) |
| Other¶ | 3 (1) | 2 (1) | 2 (1) | 3 (1) |
| Probable bacterial (no organism identified) | 52 (22) | 50 (22) | 56 (24) | 46 (20) |
| Not bacterial meningitis | 23 (10) | 15 (6) | 19 (8) | 19 (8) |
| Cryptococcal meningitis‖ | 12 (5) | 8 (3) | 8 (3) | 12 (5) |
| Mycobacterium tuberculosis | 6 (3) | 1 (0.4) | 5 (2) | 2 (1) |
| Not meningitis | 5 (2) | 6 (3) | 6 (3) | 5 (2) |
| Positive blood culture — no. (%)** | 82 (35) | 68 (29) | 69 (30) | 81 (34) |
| Blood culture unavailable — no. (%) | 6 (3) | 5 (2) | 3 (1) | 8 (3) |
| HIV-positive — no./total no. tested (%) | 194/216 (90) | 195/218 (89) | 191/215 (89) | 198/219 (90) |
| HIV status not known — no. (%) | 17 (7) | 14 (6) | 15 (7) | 16 (7) |
| Randomly assigned to receive intramuscular ceftriaxone — no. (%) | 117 (50) | 113 (49) | ||
| Randomly assigned to receive corticosteroids — no. (%) | 117 (51) | 116 (49) | ||
Plus–minus values are means ±SD.
The Glasgow Coma Scale ranges from 3 to 15, with 3 indicating that the patient is unresponsive and 15 indicating that the patient is fully alert.
Details regarding pretreatment antibiotics are available in Table S1 in the Supplementary Appendix.
Other gram-negative organisms were Escherichia coli (in 11 patients), non-typhi salmonella (in 7), Haemophilus influenzae (in 3), klebsiella species (in 3), and Enterobacter gergoviae (in 1).
Other bacteria were Staphylococcus aureus (in 2 patients) and α-hemolytic streptococci (in 3).
Of 20 patients, 10 were categorized as having probable bacterial meningitis on the basis of the cell and differential counts from the cerebrospinal fluid specimen but were found to have cryptococcal meningitis either after prolonged incubation or after repeated lumbar puncture.
Of 150 positive blood cultures, 7 were positive for Cryptococcus neoformans.