Among patients with severe sepsis and septic shock, adjunctive hydrocortisone treatment may be of benefit when fluid resuscitation and vasopressor therapy are inadequate to restore hemodynamic stability. Whether hydrocortisone is efficacious for patients with severe sepsis without shock is not clear. In a multicenter randomized placebo-controlled clinical trial that enrolled 380 adult patients with severe sepsis without septic shock, Keh and colleagues found that compared with placebo, use of hydrocortisone—200 mg for 5 days followed by dose tapering until day 11—did not reduce the risk of septic shock within 14 days. In an Editorial, Yende and Thompson discuss unresolved questions about the use of corticosteroids in patients with sepsis.
Highlights. JAMA. 2016;316(17):1731-1733. doi:10.1001/jama.2015.14562