Randomized, placebo-controlled, double blinded trial of dexamethasone in African children with sepsis

Abstract

These data indicate that a moderate dose of dexamethasone given before antibiotic therapy did not improve outcome in the pediatric patients with sepsis whom we studied.

Early Reversal of Pediatric-Neonatal Septic Shock by Community Physicians Is Associated With Improved Outcome

“…13,14 One randomized controlled trial that examined the role of high-dose hydrocortisone (50 mg/kg intravenous bolus followed by a 50-mg/kg infusion over 24 hours) in Dengue shock syndrome found significant survival benefit. 15,16 Hydrocortisone provides both glucocorticoid and mineralocorticoid effect. A randomized controlled trial of the pure glucocorticoid dexamethasone found no effect on the outcome in African children with sepsis.…”

Do Low-dose Corticosteroids Improve Mortality or Shock Reversal in Patients with Septic Shock? A Systematic Review and Position Statement Prepared for the American Academy of Emergency Medicine

“…Twenty-one of the 28 trials were excluded due to the pre-specified criteria, including the use of high-dose corticosteroids (seven trials), non-adult population (one trial), outcome of interest (mortality or shock reversal) not reported (four trials), reported only in abstract form (two trials), and non-septic shock population or septic shock data not separately reported (seven trials) (3,4,9,11,(15)(16)(17)(18)(20)(21)(22)(23)(24)(26)(27)(28)(30)(31)(32)(33)(34). Seven trials were subsequently reviewed and graded by the sepsis subcommittee and formulated into this recommendation ( Table 3).…”

Corticosteroid Treatment in Critically Ill Patients

“…Five were excluded because the study was designed to look at respiratory function in pneumonia only, not sepsis [12][13][14][15][16]. Two studies were excluded because they used children as their study population [17,18]. We excluded data from children in one study, but included the data from adults [19].…”