Objective. To determine the effect of moderate dose dexamethasone administered before antibiotics on the outcome of African children with sepsis. Methods. The design was a randomized, double blinded, placebo- controlled trial of dexamethasone (0.2 mg/kg) vs. placebo given intravenously before antibiotic therapy. Patients were recruited from the patient populations at two missionary hospitals. Primary outcome variables were determined before analysis of data. Results. Seventy-two children with sepsis were enrolled in the study. Treatment with dexamethasone was not associated with improved outcome for any six outcome variables: survival to discharge (83%, dexamethasone group; 89%, placebo group); hemodynamic stability at 48 h (33%, dexamethasone group; 49%, placebo group); median length of hospital stay (11 days, dexamethasone group; 11 days, placebo group); normal at discharge (90%, dexamethasone group; 75%, placebo group); normal at follow- up (90%, dexamethasone group; 72%, placebo group); and afebrile at 48 to 72 h(61%, dexamethasone group; 44%, placebo group). Conclusions. These data indicate that a moderate dose of dexamethasone given before antibiotic therapy did not improve outcome in the pediatric patients with sepsis whom we studied.
- sepsis syndrome
- septic shock (pediatric)