To the Editor: Dr Cruz and colleagues1 concluded that polymyxin B hemoperfusion added to conventional therapy reduced 28-day mortality in patients with severe sepsis or septic shock from intra-abdominal gram-negative infections. However, Table 2 in their article showed that gram-positive bacteria such as Enterococcus, Staphylococcus, and Streptococcus were more frequently isolated in the polymyxin B hemoperfusion group than the conventional therapy group. Therefore, the frequencies of gram-negative sepsis and severe endotoxemia seemed to be high in the conventional therapy group compared with the polymyxin B hemoperfusion group.
Kida Y. Polymyxin B Hemoperfusion and Mortality in Abdominal Septic Shock. JAMA. 2009;302(18):1968-1970. doi:10.1001/jama.2009.1608