Israel journal of medical sciences
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Review Clinical Trial
Corticosteroids in sepsis and septic shock: has the jury reached a verdict?
Mortality from septic shock remains high, despite early diagnosis, comprehensive care and monitoring, and intensive therapy. The use of high-dose corticosteroids as adjunctive therapy in septic states has been extensively debated in the literature, but no clear consensus has been reached. ⋯ Recently, however, well-designed clinical studies have consistently failed to show a beneficial effect of corticosteroid use in septic states. After re-examining the theoretical basis for the use of steroids, possible side effects, experimental results and clinical trials, it is concluded that, based upon current knowledge, high-dose corticosteroids should not be used as adjunctive therapy in human sepsis and septic shock.