Steroid therapy of septic shock

Steroid therapy in patients with septic shock has been controversial for decades. Although treatment with high-doses of corticosteroids for patients with septic shock has been shown not to be beneficial, it was believed that therapy with low-doses would be helpful. Recent studies document that steroids are beneficial only in adult septic shock patients whose blood pressure is poorly responsive to fluid resuscitation and vasopressor therapy. For the majority of septic shock patients, corticosteroids should not be used, as the benefit of reversing shock is not worth the complications of superinfection, new sepsis, and septic shock. Finally, steroid therapy should not be guided by corticotropin test results.