Hydrocortisone during Sepsis

On the basis of available evidence, current recommendations, and good clinical practice (and irrespective of the results of adrenal testing), the author, S.R. Bornstein, recommends that moderate doses of hydrocortisone (200 to 300 mg per day) should be given soon after the onset of septic shock in patients who remain hypotensive after adequate administration of fluids and vasopressor agents. Current evidence is insufficient to recommend the replacement of other steroids such as mineralocorticoids and adrenal androgens, which are also suppressed in patients with sepsis.