Osmotic therapies added to antibiotics for acute bacterial m | Figure 1

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Osmotic therapies added to antibiotics for acute bacterial meningitis

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Cochrane Review; 5 trials (451 patients with bacterial meningitis) that compared glycerol with placebo. In the studies steroids were often given as well, but this did not appear to modify any of the effects seen with glycerol.

Background:

Osmotic therapies increase the concentration of the blood by exerting an osmotic pressure across a semi-permeable membrane (such as a cell wall or blood vessel lining in the brain). This draws water from the brain into the blood, thereby reducing pressure in the brain. Potentially osmotic therapies could increase the rate of survival, or they could do harm.

Key findings

Giving glycerol, an osmotic diuretic, probably has little or no effect on death (moderate-certainty evidence), but may reduce subsequent deafness (moderate-certainty evidence) or neurological disability (low-certainty evidence).

What are the main results of the review?

This review detected no benefit from glycerol relating to death. There appeared to be marginal protection against deafness and against neurological disability. No effect on epileptic seizures at follow-up was noted. Glycerol was not associated with any severe adverse effects. The number of trials included was small and only two tested a large number of participants.

Read the full Cochrane Review here

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