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Treatment of Sepsis

Past and Future Avenues

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Abstract

In recent years, the concept has emerged that the host’s inflammatory response contributes substantially to the development of septic shock and organ failure. Experimental observations prompted large scale randomised clinical trials with a variety of agents such as glucocorticoids, ibuprofen, antiendotoxin monoclonal antibodies, antagonists of platelet-activating factor, of bradykinin or of interleukin-1 receptor, and monoclonal anti-tumour necrosis factor (TNF) antibodies or soluble dimeric TNF receptor fusion proteins.

All these major studies of immunomodulators in sepsis have yielded disappointing results despite showing promise during preliminary clinical studies. However, these recent failures do not mean that septic shock will forever remain an insurmountable medical challenge. Many lessons have been learned from these studies, and certain mistakes in their study design will be avoided in the future. Our understanding of the pathophysiology of sepsis and septic shock is increasing markedly; potential new treatment strategies are available and could be explored to improve the outcome of patients with sepsis.

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Authors and Affiliations

  1. Service of Internal Medicine, Hôpital de Zone, CH-1110, Morges, Switzerland

    Jean-Daniel Baumgartner

  2. Division of Infectious Diseases, Department of Internal Medicine, Center Hospitalier Universitaire Vaudois, Lausanne, Switzerland

    Thierry Calandra

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  1. Jean-Daniel Baumgartner
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  2. Thierry Calandra
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Baumgartner, JD., Calandra, T. Treatment of Sepsis. Drugs 57, 127–132 (1999). https://doi.org/10.2165/00003495-199957020-00001

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