We present our experience with drotrecogin alfa (activated) in 110 patients. Data were collected on diagnosis, acuity, complications and outcomes. Crude ICU and hospital mortality was high at 47.3 and 55.5% respectively (hospital SMR = 1.02). Our patients appeared to be sicker than in other published series (mean number of organ failures = 4). The rate of serious bleeding events was comparable to the PROWESS trial. Usage fell during the study period from 37 patients in 2005 to 14 patients in 2008 and is likely to reflect uncertainty over the risk-benefit profile.
BernardGRVincentJLLaterrePF. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med2001;344: 699–709.
2.
RowanKMWelchCANorthEHarrisonDA. Drotrecogin alfa (activated): real life use and outcomes for the UK. Crit Care2008;12: R58.
3.
MartinGBrunkhorstFMJanesJM. The international PROGRESS registry of patients with severe sepsis: drotrecogin alfa (activated) use and patient outcomes. Crit Care2009;13: R103.
4.
BertoliniGRossiCAnghileriA. Use of drotrecogin alfa (activated) in Italian intensive care units: the results of a nationwide survey. Intensive Care Med2007;33: 426–34.
5.
KanjiSPerreaultMMChantC. Evaluating the use of drotrecogin alfa (activated) in adult severe sepsis: A Canadian multicentre observational study. Intensive Care Med2007;33: 517–23.
6.
MackenzieAF. Activated protein C: do more survive?Intensive Care Med2005;31: 1624–26.
7.
DellingerRPLevyMMCarletJM. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med2008;36: 296–327.
8.
AbrahamELaterrePFGargR. Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med2005;353: 1332–41.
9.
RidleyS. Activated protein C: do more survive?Intensive Care Med2006;32: 608.
10.
ParilloJE. Severe sepsis and therapy with Activated Protein C. N Engl J Med2005;353: 1398–400.
11.
VincentJLBernardJRBealeR. Drotrecogin alfa (activated) treatment in severe sepsis from the global open label trial ENHANCE: further evidence for survival and safety and implications for early treatment?Crit Care Med2005; 33: 2266–77.
12.
FinferSRanieriVMThompsonBT. Design, conduct, analysis and reporting of a multi-national placebo-controlled trial of activated protein C for persistent septic shock. Intensive Care Med2008;34: 1935–47.
