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February 9, 1963

The Effectiveness of Hydrocortisone in the Management of Severe Infections: A Double-Blind Study

Author Affiliations

The cooperative study group is composed of Ivan L. Bennett, Jr., MD, Baltimore, Maxwell Finland, MD, Boston, Morton Hamburger, MD, Cincinnati, Edward H. Kass, MD, PhD, Boston, and Mark Lepper, MD, and Burton A. Waisbren, MD, Chicago.

JAMA. 1963;183(6):462-465. doi:10.1001/jama.1963.63700060029012

THE ROLE OF adrenocorticosteroids in the management of infectious diseases has been a subject of much controversy.1-3 On the one hand, a large amount of information has accumulated to show that corticosteroids depress resistance to infection by reducing inflammation, inhibiting antibody formation, altering reticuloendothelial activity, and perhaps by other means yet to be discovered. On the other hand, corticosteroids have been shown, under appropriate conditions, to be antiendotoxic and antipyretic, and to influence vascular reactivity in a manner that might conceivably be beneficial to the infected individual. Perhaps most important has been the effect of corticosteroids in bringing about amelioration of distressing symptoms of various kinds; despite our ignorance of the mechanisms by which these changes have occurred, their dramatic quality has suggested that the use of corticosteroids might be highly beneficial to infected patients. There were thus reasons for suspecting that steroids might be harmful to the infected