Role of glucocorticosteroids in the treatment of infectious diseases.

The role of glucocorticosteroids in the management of infectious diseases in man remains controversial, although experimental data obtained both in in vitro systems and in experimental infections in animals provide evidence of a beneficial effect of such treatment. Their use in the treatment of Pneumocystis carinii pneumoniae and severe typhoid fever seems indicated. A beneficial effect on the treatment of bacterial meningitis needs to be confirmed. Sufficient data are now available that argue against steroid treatment in septic shock. However, new treatment modalities such as monoclonal antibodies against endotoxin and inflammatory mediators are currently being developed to modulate infectious inflammation. This could also bring a renaissance of the role of glucocorticosteroids in the treatment of infectious diseases.