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Volume 358:2068-2071 May 8, 2008 Number 19
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Corticosteroids for Septic Shock

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by Sprung, C. L.
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To the Editor: On the basis of the Corticosteroid Therapy of Septic Shock (CORTICUS) study, Sprung et al. (Jan. 10 issue)1 report that hydrocortisone does not improve survival among patients with septic shock. However, it is disturbing that of the 357 study patients with culture-positive sepsis, 86 (24%) were considered not to have received appropriate antimicrobial therapy. This was determined retrospectively by a clinical evaluation committee. The actual mortality rates among patients receiving appropriate antimicrobial therapy as compared with those receiving inappropriate antimicrobial therapy are not provided. Antimicrobial agents remain the cornerstone of therapy for sepsis.2 However, this study shows . . . [Full Text of this Article]



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