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In cerebral malaria, a double-blind trial has shown that the use of corticosteroids is associated with prolongation of coma and a higher incidence of pneumonia and gastrointestinal bleedingin patients who survive. These events were especially notable in patients who were treated with intravenous corticosteroids. As a result, the Committee concluded that corticosteroids should be avoided during treatment with cerebral malaria and during treatment of convalescence and when respiratory support is needed in patients who do not survive. This recommendation has been endorsed by WHO and approved by the Institute of Medicine (IOM). Corticosteroid injections for neonates Neonates are of exceptional risk of death from cerebral malaria; no drug is universally effective. Treatment with corticosteroids for neonates consists of two distinct types of injections: intravital corticosteroid injections (intracorporeal/intraperitoneal) and intracorporeal corticosteroid injections (intracorporeal/intraperitoneal). Intracorporeal or intracorporeal corticosteroid injections Intracorporeal intravitreal corticosteroid injection (IVIC) are the mainstay of the treatment for neonates. Intracorporeal infusions require the use of a central IV line and should be administered continuously from the beginning of life (approximately 18 to 24 weeks of age); when administered intravitreal, the intravenous dose is usually 200 to 400 micrograms (5.8 to 10.1 times the maximum dose recommended by the FDA for a given dose of corticosteroids). Intracorporeal infusions occur in the first five days of life and are associated with the most severe adverse effects (death) after one year of life. The duration of this period varies according to the infant's age and the degree of immunodeficiency, but often begins well before birth. Infants who have had intravitreal corticosteroids before birth may require repeated administrations of intravitreal corticosteroids after delivery. The most frequent adverse effects may be gastrointestinal and respiratory complications, neonatal death, and/or postpartum hemorrhage. However, the benefits of this type of treatment often outweigh its risks. Intravenous corticosteroids Intravenous corticosteroids are given orally (IVC) or intramuscularly (IVMC) with intramuscular drops after induction of coma in neonates. Infants in whom the use of IVCs has been suggested due to the severity of brain damage from the malaria are routinely given IVCs with intramuscular drops, and Similar articles: