Low-Dose Steroid Therapy Reduces Mortality from Septic Shock

In patients with septic shock and relative adrenal insufficiency, low-dose corticosteroid therapy reduced mortality without increasing adverse events.

Because septic shock may be associated with relative adrenal insufficiency, corticosteroid replacement has been advocated. Trials of short-course, high-dose corticosteroid therapy have not been successful, however. These authors evaluated treatment with low-dose corticosteroids in a controlled, randomized, double-blind study conducted at 19 intensive care units in France.

Three hundred adults who met each of 6 clinical or laboratory criteria for septic shock (including systolic arterial blood pressure <90 mm Hg for at least 1 hour despite adequate fluid replacement and treatment with dopamine, epinephrine, or norepinephrine) received placebo or hydrocortisone (50-mg IV bolus every 6 hours) and fludrocortisone (50-µg oral dose once daily) for…

Reviewing Author

John A. Marx, MD, FACEP