Activated drotrecogin alfa for treatment of severe sepsis in Singapore

Abstract

Severe sepsis is common in intensive care and has a high associated mortality. A recent breakthrough among the novel therapies is the use of intravenous recombinant human activated protein C Xigris™ (drotrecogin alfa activated) which reported a 19.4 percent reduction in the relative risk of death at 28 days. This is translated to 1 additional life saved for every 16 patients treated with drotrecogin alfa activated by 28 days, considerably lower than the number needed to treat of 56 to prevent one death by 35 days for intravenous thrombolytic treatment in acute myocardial infarction-a widely accepted benchmark of effective clinical practice. We described our initial experience with Xigris in 4 patients who were admitted to our intensive care unit (ICU) for severe sepsis. All patients were ventilated and had Acute Physiology and Chronic Health Evaluation (APACHE) II scores equal or greater than 25. Three out of 4 were discharged alive from ICU and there was no serious bleeding complication.