Low-Dose Steroids in Sepsis Are Associated with Increased In-Hospital Mortality

Research has provided conflicting results regarding the benefit of steroids in septic shock. As part of the Surviving Sepsis Campaign, investigators analyzed data from 17,847 patients who were eligible for low-dose steroids because they required vasopressor therapy after fluid resuscitation. Eligible patients had at least two systemic inflammatory response syndrome criteria, at least one organ dysfunction criterion, and a suspected site of infection.

Just over half of patients received low-dose steroids (50 mg intravenously four times per day or 100 mg three times per day), most within 8 hours of presentation. Patients in Europe and South America were more likely to receive steroids than those in North America (59%, 52%, and 46%, respectively). Patients with pneumonia and those on mechanical ventilation were more likely to receive steroids than their counterparts.

Hospital mortality was significantly higher in patients who received low-dose steroids than in those who did not (41% vs. 35%; adjusted odds ratio, 1.18).