Finally, an Effective New Treatment for Severe Sepsis?

Patients with severe sepsis have reduced levels of activated protein C, a substance with antithrombotic and anti-inflammatory properties. This observation led researchers to conduct an industry-sponsored, multicenter, randomized trial to compare a 96-hour infusion of recombinant activated protein C (drotrecogin alfa activated) and placebo in 1690 patients with severe sepsis.

Enrollment criteria were extensive, but basically, the trial included patients with known or suspected sources of infection, clinical findings of systemic inflammatory response syndrome, and 1 or more organs with sepsis-induced dysfunction. The lungs and the abdomen were the most common sources of infection; a third of the patients had positive blood cultures; and, among…