Comparative efficacy and safety of hydrocortisone-based regimens in septic shock: A network meta-analysis
Authors' conclusion
Higher-dose hydrocortisone was associated with improved survival but also increased adverse events, whereas adjunctive fludrocortisone may provide additional benefit without substantially increasing complications.
Study context
- Population
- Adults with septic shock
- Participants
- 7,908 adults · 21 trials
- Comparison
- Hydrocortisone and/or fludrocortisone regimens vs placebo
- Outcome
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsPRISMA-compliant, frequentist random-effects model
- PRISMA-compliant
- Frequentist random-effects model
Pooled result
As reported in the abstract
Each group vs placeboOdds ratio (95% CI)
Hydrocortisone ≥300 mg/day
0.53(0.29–0.96)
Hydrocortisone 200-299 mg/day + fludrocortisone 50 μg/day
0.78(0.64–0.96)
Safety
Superinfection
- Higher hydrocortisone doses associated with increased superinfection risk; fludrocortisone appeared to attenuate this effect
Gastrointestinal hemorrhage
- Increased risk across regimens, estimates imprecise
Original publication
Comparative efficacy and safety of hydrocortisone-based regimens in septic shock: A network meta-analysis. J Crit Care. Published 22 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →