Review of corticosteroid treatment in sepsis and septic shock: pro or con

The use of glucocorticoids in high dosage for the prevention and treatment of sepsis, septic shock, and ARDS has been controversial. The state of our knowledge has been reviewed, particularly to include some recent critical contributions. It is possible that glucocorticoids have a place in the treatment of gram-negative bacteremia, because the evidence in this situation is equivocal. There is no evidence that such therapy is indicated in other septic states, nor is there evidence that glucocorticoids prevent ARDS or improve the outcome. There are inadequate data to state categorically that glucocorticoid therapy in sepsis is harmful.