What is the treatment for septic shock in coccidioidomycosis?

Updated: Aug 27, 2019
  • Author: Duane R Hospenthal, MD, PhD, FACP, FIDSA, FASTMH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The treatment of septic shock associated with coccidioidomycosis relies on the use of antifungal therapy and appropriate resuscitative and supportive measures. However, this entity carries a poor prognosis.

Two patients with coccidioidomycosis and septic shock treated with drotrecogin alfa (activated protein C) were the first survivors reported. Drotrecogin alfa was withdrawn from the worldwide market October 25, 2011. In the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS)-SHOCK clinical trial, drotrecogin alfa failed to demonstrate a statistically significant reduction in 28-day all-cause mortality in patients with severe sepsis and septic shock. Trial results observed a 28-day all-cause mortality rate of 26.4% in patients treated with activated drotrecogin alfa compared with 24.2% in the placebo group of the study.


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