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In the 1980s, anecdotal reports of substantially lower short-term mortality in patients with septic shock who received high-dose corticosteroids (e.g., 1–2 g methylprednisolone bolus) resulted in widespread adoption of this practice; however, subsequent controlled studies showed no benefit. Two recent systematic reviews of longer-term lower-dose steroid use suggested that 200 mg to 300 mg of hydrocortisone (equivalent to 50–75 mg of prednisone) for 5 to 7 days was beneficial for shock patients, but, subsequently, the large randomized CORTICUS trial yielded conflicting results (JW Gen Med Jan 9 2008). Current practice guidelines recommend corticosteroid use only in severely ill patients who do not respond to fluid resuscitation and vasopress…