My brother has severe sepsis--should he receive Xigris?

Six years ago, a publication in a quite well known scientific medical journal brought hope and a good dose of optimism to sepsis therapy and the critical care community. For the first time, a careful randomized controlled trial in patients with severe sepsis or septic shock seemed to show a clearly beneficial effect of a new drug, i.e. of activated recombinant human protein C. This new treatment possibility was welcomed as an important breakthrough and a hope for a better management of a deadly disease. However, further evaluation of the results of the trial and new investigations did not confirm entirely the initial optimism. As a consequence, the adequate indications for this expensive drug remain controversial.