Glucocorticoid therapy in sepsis/shock caused by gram-negative microorganisms.
A review of the literature reveals that glucocorticoids have: 1) a protective effect both in vitro and in vivo against bacterial endotoxins and exotoxins, and 2) a protective or therapeutic effect in sepsis/shock caused by Gram-negative microorganisms. At the Columbia Presbyterian Medical Center, the 1968-1973 mortality rate for general sepsis/shock due to Gram-negative organisms was 16.6 percent and for urologic sepsis/shock 15.3 percent. This low rate was the result of early diagnosis and early use of massive dosages of glucocorticoids (hydrocortisone, methylprednisolone, dexamethasone), beta-adrenergic isoproterenol, and bactericidal antibiotics (gentamicin, kanamycin, carbenicillin, cephalothin-cefazolin, ampicillin).
D000667:Ampicillin / Q000627:therapeutic use; D002228:Carbenicillin / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D002512:Cephalothin / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004731:Endotoxins; D005839:Gentamicins / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007545:Isoproterenol / Q000627:therapeutic use; D007612:Kanamycin / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D008833:Microcirculation / Q000187:drug effects; D009519:New York City; D018805:Sepsis / Q000188:drug therapy*; D012772:Shock, Septic / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology
D004731:Endotoxins; D005839:Gentamicins; D005938:Glucocorticoids; D007612:Kanamycin; D000667:Ampicillin; D003907:Dexamethasone; D002228:Carbenicillin; D002437:Cefazolin; D007545:Isoproterenol; D002512:Cephalothin; D006854:Hydrocortisone; D008775:Methylprednisolone