Sepsis: the role of steroids and monoclonal antibodies in treatment.

Septic shock is currently the most common cause of death in noncoronary intensive care units in the United States. The pathogenesis of sepsis involves a variety of cytokine and noncytokine mediators, which, when activated, can result in a self-perpetuating cascade. This systemic response to infection is a frequent cause of multi-organ system failure and death. Treatment has traditionally focused on antibiotic therapy, but this has not significantly changed patient outcomes. Steroids have been shown to be of little or no value and studies evaluating monoclonal antibodies that target the mediators of the sepsis cascade have not produced promising results.