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November 1, 2016

Evaluating Glucocorticoids for Sepsis: Time to Change Course

Author Affiliations
  • 1Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
  • 3Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston
  • 4Harvard Medical School, Boston, Massachusetts
JAMA. 2016;316(17):1769-1771. doi:10.1001/jama.2016.13904

For decades, researchers have tested glucocorticoids such as hydrocortisone, methylprednisolone, prednisolone, and dexamethasone, in varying doses, for the related conditions of pneumonia, sepsis, septic shock, and acute respiratory distress syndrome.1-4 The overarching rationale has been that glucocorticoids could mitigate exaggerated and potentially deleterious aspects of the host’s inflammatory response. Corticosteroids have typically been prescribed to target the acute phase of these conditions, although they have also been used later to improve resolution of inflammation and organ dysfunction in instances such as nonresolving acute respiratory distress syndrome.