Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes.
Population: Children or adults with acute bacterial meningitis ᵃ
Intervention: Glycerol with or without corticosteroids ᵇ
Comparison: Placebo with or without corticosteroids ᵇ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Mortality (follow‐up up to 6 months) | No statistically significant difference | Moderate |
Neurological disability (follow‐up 40 days to 6 months) | No statistically significant difference | Low |
Seizures (follow‐up 40 days to 6 months) | No statistically significant difference | Low |
Hearing loss (follow‐up 40 days to 6 months) | Favors intervention ᶜ | Moderate |
Adverse effects: nausea, vomiting, diarrhea | No statistically significant difference | Very Low |
Adverse effects: gastrointestinal bleeding | No statistically significant difference | Moderate |
Note The Cochrane Review which underpins this Cochrane Clinical Answer (CCA) notes that glycerol may provide a small beneficial effect for deafness in children. However, further research is required. ᵃ Of the five included studies, four were in children (age range 2 months to 16 years) and one in adults (age range not reported). See CCA for more details. ᵇ All participants received broad-spectrum antibiotics. ᶜ Subgroup analysis found no statistically significant difference between groups for participants who received corticosteroids. See CCA for more details.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- In children with acute bacterial meningitis, is there randomized controlled trial evidence to support adding corticosteroids to standard treatment with antibacterial agents?
- In adults with acute bacterial meningitis, is adding corticosteroids to standard treatment with antibacterial agents helpful?
- How does glycerol compare with placebo for people with acute bacterial meningitis treated with antibiotics?
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