American Board of Internal Medicine (ABIM) Certification Practice Exam

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What medication is beneficial in cases of bacterial meningitis caused by Streptococcus pneumoniae?

Ibuprofen
Dexamethasone
Cephalexin
Ciprofloxacin

The correct answer is: Dexamethasone

Dexamethasone is beneficial in cases of bacterial meningitis, particularly for infections caused by Streptococcus pneumoniae. Its use is rooted in the understanding that inflammation plays a significant role in the complications associated with bacterial meningitis. By administering dexamethasone, which is a corticosteroid, it can help to reduce the inflammatory response that often contributes to neurological damage and other adverse outcomes. Clinical guidelines suggest that dexamethasone should be given alongside appropriate antibiotics to decrease the risk of hearing loss and other complications linked to the inflammatory process that occurs in the central nervous system during bacterial infections. It is typically most effective when started as soon as the diagnosis of meningitis is confirmed or suspected. Thus, it plays a crucial role in the management of severe bacterial meningitis caused by pathogens like Streptococcus pneumoniae.