Participating Sites and National Principal Investigator

Dr. Manish Sadarangani

What Do We Want To Know?

Bacterial meningitis is a serious infection that affects approximately 150–300 Canadian infants under 90 days of age each year. In older children, dexamethasone (a steroid) is recommended alongside antibiotics to improve outcomes. However, there is currently no high-quality evidence to guide its use in young infants. 

The BOBBi trial aims to determine whether giving dexamethasone to babies with suspected bacterial meningitis increases the number who survive without long-term difficulties. 

Across the UK and Canada, BOBBi will recruit 1,123 babies over approximately four and a half years.  

The main outcome we are studying is survival without moderate or severe neurodevelopmental impairment at 24 months of age (corrected for prematurity). We will compare outcomes between babies who receive dexamethasone and those who do not to determine whether adding steroids improves long-term health and developmental outcomes. 

How Are We Doing It?

We will recruit babies up to 90 days of age who doctors think may have bacterial meningitis. Babies will be randomly assigned to one of two groups: 

• One group will receive dexamethasone in addition to usual antibiotic treatment. 

• The other group will receive usual antibiotic treatment alone. 

Because meningitis in young babies can have long-term effects, we will follow babies until they are 24 months old (corrected for prematurity). Parents will be asked to complete questionnaires at hospital discharge and at follow-up time points. We will also review medical records to understand each baby’s health, development, hearing, vision, and neurological outcomes.  

How Is The Project Going?

The trial protocol is nearing finalization. Regulatory and ethics submissions will begin shortly. Study start-up activities are underway, with recruitment in Canada anticipated to begin in mid-2026. 

 Who Is Included?

Babies up to 90 days of age who doctors think may have bacterial meningitis may be recruited, and the research team will follow babies until they are 24 months old in this project.