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A comparison of the effectiveness of erythropoietin and dexamethasone therapy in Streptococcus pneumoniae induced meningitis in rabbits.

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Background: Although bacterial meningitis can be seen at all ages, it is more common in childhood. The primary treatment option in bacterial meningitis is antibiotics. Ancillary therapies are required due to inflammation developing secondary to antibiotherapy. The purpose of this study was to investigate whether Erythropoietin (EPO), which has recently come to prominence with its anti-inflammatory effects, can be used as an alternative to steroid therapy, with its known side-effects and debatable efficacy, in the treatment of meningitis. Methods: Forty female New Zealand rabbits weighing 1900-3100 g were divided into six groups. The study groups consisted of seven animals each and the control group of five. Streptococcus pneumoniae at 1 × 107 colony forming units (in 0.2 ml 0.9% NaCl) was injected into the cisterna magna of the induced meningitis groups, while the control group received saline solution. Seven rabbits with induced meningitis received 1000 IU/kg EPO, 7 received EPO+antibiotic, 7 received 0.25 mg/kg dexamethasone+antibiotic and 7 received dexamethasone. Cerebrospinal fluid (CSF) and serum specimens were collected at the end of 24 h and the rats were euthanized. IL-1β, TNF-α and CRP levels were investigated from CSF and serum. SPSS software was used for statistical analysis. Results: Serum and CSF IL-1β, TNF-α and CRP values in the groups with induced meningitis were significantly higher than those in the control group. No significant difference in terms of serum and CSF CRP, TNF-α and IL-1β values was determined between the group with induced meningitis alone and the group receiving EPO therapy (p values p=0.949, p=0.159, p=0.655, p=0.848, p=0.749 and p=0.655, respectively). Conclusion: Our study results show that EPO has no effect on serum or CSF IL-1β, TNF-α and CRP in pneumococcal meningitis in rabbits. To the best of our knowledge, this is the first study to investigate the effect of EPO on CRP, IL-1β and TNF-α levels in serum and CSF in meningitis.