[Therapeutic perspectives of severe infectious states].
Mortality from sepsis is still unacceptably high which justifies a new therapeutic approach complementary of antibiotics and symptomatic treatment. Recent advances in the understanding of sepsis and septic shock opened new fields of therapeutic intervention. Nevertheless, there are so many potential targets that is hard to make a choice for evaluation of these new agents: anti-endotoxin (monoclonal antibodies, lipid A analogs, BPI), anticytokines (monoclonal antibodies, soluble receptors, IL-1 receptor antagonist), anti-inflammatory agents (non-steroidal anti-inflammatory agents, anti-PAF, reactive oxygen radicals scavengers...), extracorporeal removal of toxic molecules, inhibition of the adhesion of polymorphonuclear leucocytes on endothelial surface, optimisation of general and regional circulation. The use of these new and often costly drugs must rely on multicenter randomized clinical trials since extrapolation to the human of experimental data gathered in animal studies are hazardous.
Offenstadt
G
G
Service de réanimation polyvalente, hôpital Saint-Antoine, Paris.
Guidet
B
B
Barakett
V
V
D016207:Cytokines / Q000037:antagonists & inhibitors; D004731:Endotoxins / Q000037:antagonists & inhibitors; D006801:Humans; D011446:Prospective Studies; D012772:Shock, Septic / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*
D016207:Cytokines; D004731:Endotoxins
Perspectives thérapeutiques des états infectieux graves.