Adjunctive Therapy in Septic Shock and Severe Sepsis

In two prospective, multicenter trials, researchers examined the roles of adjunctive hydrocortisone, intensive insulin therapy, and colloid resuscitation in patients with sepsis.

Despite the use of antimicrobials, mortality rates remain very high in patients with severe forms of sepsis. The role of adjunctive therapies is uncertain. In two recent multicenter, randomized trials, researchers investigated the use of such therapies.

Sprung and colleagues compared hydrocortisone with placebo in a multinational, double-blind trial involving 499 adults with septic shock. The primary outcome measure was 28-day mortality among patients who did not have a response to a corticotropin test. Mortality also was evaluated in two other cohorts: patients who did respond to a corticotropin test and the overall group. In all three study cohorts, mortality rates were similar between treatment groups.

In an open-label, two-by-two factoria…

Reviewing Author

Larry M. Baddour, MD

Disclosures

RoyaltiesUpToDate, Inc. (Authorship duties)

Larry M. Baddour, MD

Disclosures

RoyaltiesUpToDate, Inc. (Authorship duties)