Dose of steroids in tb meningitis in children

WHO recommends initial adjuvant corticosteroid therapy in children and adolescents with tuberculosis meningitis with either:

• dexamethasone 0.3-0.6 mg/kg/day initially for about 4 weeks then tapered over 2-4 weeks
• prednisone 2-4 mg/kg/day (maximum 60 mg/day) initially for about 4 weeks then tapered over 2-4 weeks

BIS recommends corticosteroids regardless of disease severity:

• recommended regimen for patients > 14 years old dexamethasone 0.4 mg/kg/day with taper over 6-8 weeks
• recommended regimen for children ≤ 14 years old prednisolone 4 mg/kg/day or dexamethasone 0.6 mg/kg/day for 4 weeks followed by 4-week taper