Experimental pneumococcal and staphylococcal sepsis: effects of hydrocortisone and phenoxybenzamine upon mortality rates.

The institution of appropriate antimicrobial therapy after a critical period in infectious diseases of man and experimental animals may fail to pre-vent death (1-6). In these circumstances, death is probably attributable to biochemical or physio-logic derangements that are not reversed by elimi-nation of the infecting microorganisms (5). In some instances the lethal outcome is related to the occurrence of acute circulatory insufficiency or shock (3). Adrenergic blocking agents and adrenal corti-costeroids have been used to reduce mortality from shock due to trauma, hemorrhage, and endotoxin (7-11). Adrenal corticosteroids may alter mani-festations of severe infection such as fever, toxicity, and inflammatory response to promote a sense of well-being and hasten recovery (12-15). It has not been firmly established, however, that either adrenal corticosteroids or adrenergic blocking agents can reduce mortality from severe bacterial infections. Previously, it was found that pneumococcal sep-sis in rabbits was associated with progressively decreasing cardiac output, progressively rising peripheral vascular resistance, and terminal hy-potension (3). Recent studies have shown that staphylococcal sepsis in rabbits produces opposite effects, with progressively increasing cardiac out-put, progressively decreasing peripheral vascular