ABSTRACT
The development of antibiotics in the second half of the twentieth century led to dramatic reductions in the mortality rates of many infectious diseases. However, the mortality rate of a subset of acute infections associatedwith shock and organ dysfunction remains high at about 30% to 60% despite modern antibiotics and critical care (1). Septic shock is a relatively common problem; there are about 750,000 cases of severe sepsis due to bacterial or fungal infections each year in the United States (1). The incidence of septic shock is increasing. From 1979 to 1987 the percentage of infectious disease diagnoses that included sepsis increased from approximately 10% to 25% (1). This increase may be due to the increased use of cytotoxic and immunosuppressive drugs, aging of the patient population, the increased use of invasive medical devices, and an increase in antibiotic resistant organisms.
