"In our hospital, patients with less severe septic shock are being treated with vasopressin," Russell said.
But perhaps the most important factor in treatment is time, said Dr. Joseph E. Parrillo, a professor of medicine at Robert Wood Johnson Medical School in Camden, N.J.
"Two previous papers suggest that the support you give to the patient, fluids and a vasopressor, are only effective if instituted within the first few hours after the onset of septic shock," Parrillo said. "One paper also suggested that giving an antibiotic early made a difference, with a 20 percent death rate if an antibiotic was given in the first hour, and 60 percent if given by hour six."
The choice of antibiotic to treat the infection underlying the condition is also important, he said. "It makes a difference if you use antibiotics to which the infectious organism is sensitive," Parrillo said. A broad-spectrum antibiotic is adequate in most cases, he added.
Recent guidelines issued in a joint effort by 11 medical organizations, led by the Society of Critical Care Medicine, stress the need for early antibiotic treatment, Parrillo said. The guidelines do not stress the use of one artery-tightening medication over another, but, "the feeling is that there is no reason to use vasopressin," he said.
Causes and treatment of septic shock are described by the U.S. National Library of Medicine.
SOURCES: James A. Russell, professor, medicine, University of British Columbia, Vancouver, British Columbia, Canada; Joseph E. Parrillo, M.D., professor, medicine, Robert Wood Johnson Medical School, Camden, N.J.; Feb. 28, 2008, New England Journal of Medicine
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