Pharmacotherapy of sepsis

During the past few years, many promising new agents for the treatment of sepsis have been studied to varying degrees in vitro as well as in vivo in animals and humans. Although there is a relative plethora of animal data, full-scale clinical trials of size sufficient to yield clear answers are rare. Many of the agents appear to hold promise based on preliminary data in animals or from small human studies, and some are undergoing multicenter clinical investigation. At present, however, none of the agents discussed clearly has shown survival benefit when administered to patients with sepsis. Certainly, none can be recommended as standard therapy, and others such as glucocorticoids should be avoided. Nevertheless, the pharmacotherapy of sepsis remains an area of intense research, and ongoing clinical trials as well as continuing basic research into the pathophysiologic mechanisms of sepsis yet may yield a well-studied drug that offers survival benefit to patients with sepsis.