BMJ  2007;334:608 (24 March), doi:10.1136/bmj.39156.609271.80

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New treatment for sepsis disappointing in children

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Drotrecogin alfa, a recombinant human activated protein C, is a new treatment for severe sepsis. At least one trial has shown that it reduces mortality in adults, so researchers were "profoundly disappointed" to find that it may not work so well, if at all, in children. In the first randomised placebo controlled trial, children given the new drug did no better than controls on any outcome measure; organ failure recovered at about the same rate as controls, and almost an identical proportion of each group died within 28 days (17.5% (41/235) of controls v 17.2% (41/239) in the treatment group; P=0.93).

Drotrecogin alfa did not look particularly effective in this trial, but at least it looked safe. Despite its anticoagulant properties, no excess bleeding complications occurred in children treated with the active agent, except possibly in those aged under 60 days or weighing less than 4 kg. The researchers (who . . . [Full text of this article]


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