Received: 12 May 2026
Accepted: 12 June 2026
Published online: 17 June 2026
UDC 616.831.9-002-053.2:615.357:616.28-008.14
DOI: 10.53511/pharmkaz.2026.3.3
GLUCOCORTICOSTEROIDS IN ADJUNCTIVE THERAPY FOR BACTERIAL MENINGITIS
IN CHILDREN: EFFICACY AND SAFETY IN THE PREVENTION OF SENSORINEURAL
HEARING LOSS
Kim T.V. ¹, Piven L.I. ¹, Yelemesova K.B. ¹, Kim D.D. ¹, Nikolaeva T.L. ¹
¹ NJSC «Karaganda Medical University», Karaganda, Kazakhstan
Introduction. Bacterial meningitis in children is associated with a high risk of persistent neurological sequelae, among which sensorineural hearing loss is of particular importance: it develops even when treatment is successful and can profoundly affect a child’s quality of life. Glucocorticosteroids are included in the treatment regimen with the aim of
limiting the inflammatory cascade and preventing secondary damage to nervous tissue. However, the available data on their efficacy are scattered and often contradictory; systematizing this evidence is therefore a necessary step toward
clarifying management strategies for such patients.
Objective. To review the literature on the use of glucocorticosteroids in the combination therapy of bacterial meningitis in children, with emphasis on their role in preventing delayed sensorineural hearing loss.
Materials and methods. A literature analysis was conducted in the PubMed and Cochrane Library databases using keywords; Russian-language publications from CyberLeninka were additionally included. After screening the studies for relevance and currency, the final sample comprised 29 articles published between 2003 and 2024.
Results. Early administration of glucocorticosteroids concurrently with the initiation of antibacterial therapy statistically significantly reduces the risk of sensorineural hearing loss in children with bacterial meningitis. Dexamethasone administered within the first hours after diagnosis limits the inflammatory response and thereby protects cochlear hair
cells from damage: according to the included studies, the incidence of both bilateral and unilateral hearing loss decreases by 30-50%, depending on the etiology of the disease. The most convincing preventive effect has been documented in meningitis caused by Haemophilus influenzae type b and Streptococcus pneumoniae.
Discussion. The data obtained confirm the efficacy of glucocorticosteroids in bacterial meningitis caused by S. pneumoniae and H. influenzae; however, it is premature to extend this conclusion to all etiological forms of the disease. The evidence base for a number of pathogens remains insufficient, the results of individual studies are contradictory, and
data on newborns and patients in resource-limited settings are virtually absent.
Conclusions. Adjunctive GCS therapy for bacterial meningitis in children has demonstrated efficacy in reducing the risk of sensorineural hearing loss, primarily in pneumococcal and Hib etiology. The question of efficacy in newborns and in meningitis of other etiologies remains open. To resolve it, multicenter studies with separate analyses by pathogen, age group, and resource context are required: only in this way can it be determined whether the benefit of GCSs is universal or fundamentally etiology-dependent.
Keywords: bacterial meningitis, children, complications, sensorineural hearing loss, glucocorticosteroids dexamethasone.
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