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).