Patients with septic shock benefit from a combination of hydrocortisone-fludrocortisone therapy (4% lower release to hospice)

Medical Xpress / Boston University School of Medicine / JAMA Internal Medicine ^ | March 27, 2023 | Nicholas A. Bosch et al

[ConservativeMind]

Sepsis occurs in approximately 1.7 million hospitalizations in the U.S. with in more than a third of hospitalizations resulting in death. Patients with septic shock benefit from steroid medications (corticosteroids) to reduce shock duration and potentially decrease the chance of dying. However, it is unclear if one of the two main frequently used steroid regimens (hydrocortisone alone versus hydrocortisone and fludrocortisone together) is better than the other regimen.

A new study shows that patients receiving a combination of hydrocortisone and fludrocortisone had lower death rates and discharge to hospice compared to those who only received hydrocortisone.

"Our results provide robust evidence that one steroid regimen is superior to the other regimen and, in absence of further clinical trials, directly inform the choice of steroids in patients with septic shock," said corresponding author Nicholas Bosch MD, MSc.

To compare the effectiveness of both treatment regimens, the researchers used a large multicenter database made up of approximately 25% of U.S. hospitalizations and an observational study design that was intended to mimic a randomized clinical trial to compare the outcome of death or discharge to hospice between patients who received the regimen of hydrocortisone and fludrocortisone to those who received hydrocortisone alone.

They found that the regimen of hydrocortisone and fludrocortisone together was superior to hydrocortisone alone; on average, patients who received hydrocortisone and fludrocortisone died or were discharged to hospice approximately four percent less of the time compared to patients who received hydrocortisone alone.

[ConservativeMind]

It may not seem like a lot, but equate hospice with likely death, and you realize it’s better to get better.

[ConservativeMind]

The “Take Charge Of Your Health” Ping List
This high volume ping list is for health articles and studies which describe something you or your doctor, when informed, may be able to immediately implement for your benefit.

Email me to get on either the “Common/Top Issues” (20 - 25% fewer pings) or “Everything” list.