To the Editors:

In the guest editorial titled, “Meeting Unmet Needs in Patients With Sepsis: The Role of Drotrecogin Alfa (Activated)” (March 2003:94–97), Dr Morris offers compelling arguments for this contemporary addition to our armamentarium against sepsis in the intensive care unit. I am, however, troubled by the author’s assertion that, “If a therapeutic agent is available that can significantly reduce mortality, and a patient meets the guidelines mandated by the Food and Drug Administration (FDA) for treatment, then rationing that treatment could be considered unethical.”

The FDA approved drotrecogin alfa (activated) in November 2001 for use in adult patients with severe sepsis who are at high risk of death.1 In doing so, the FDA acknowledged the scientific validity of data submitted by Eli Lilly and Company. The manufacturer labeling approved by the FDA is for the reduction of mortality in adult patients with severe sepsis (sepsis associated with...

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