Our aim was two compare two different dexamethasone administration schedules in pneumococcal meningitis: short course (48 h) and long course (96 h) treatment. We diagnosed 18 pneumococcal meningitis treated with the two different schedules. We found a statistically significant longer duration of primary fever in patients who received dexamethasone for two days. We found no differences in the appearance of secondary fever, or in the development of severe neurological handicaps, or death between the two groups. We conclude that they are no significant differences between the two treatment schedules and that there is a need for developing early prognostic markers and adjuvant therapies that improve the outcome of patients with pneumococcal meningitis. © 2009 Asociacin Espanola de Pediatra. Publicado por Elsevier Espaa, S.L. Todos los derechos reservados.