What should be administered prior to antibiotics in patients with bacterial meningitis?

In patients with bacterial meningitis, administering dexamethasone prior to starting antibiotics is important for managing inflammation and preventing complications associated with the condition. Dexamethasone is a corticosteroid that helps reduce the inflammatory response within the central nervous system, which can significantly benefit patient outcomes, particularly in cases of bacterial meningitis caused by Streptococcus pneumoniae. Research has shown that pre-treatment with dexamethasone can lower the risk of neurological complications and improve survival rates by mitigating the inflammatory effects that can occur due to the infection.

Other options like ibuprofen and aspirin are non-steroidal anti-inflammatory medications (NSAIDs) used primarily for pain relief and fever reduction but do not address the inflammatory cascade associated with bacterial meningitis effectively. Hydrocortisone is also a steroid but is not the first choice in this scenario and is often reserved for other indications rather than for use in bacterial meningitis treatment prior to antibiotic administration. Thus, dexamethasone is the most appropriate choice in this context, aligning with clinical guidelines emphasizing its role in the management of bacterial meningitis.