Steroid use in sepsis is controversial. For example, fludrocortisone–hydrocortisone together may improve survival in septic shock, while hydrocortisone alone may not.

A recent subgroup analysis of the APROCCHSS trial suggested that mortality benefits of fludrocortisone–hydrocortisone versus placebo were heterogeneous; participants with community-acquired pneumonia (CAP)-related septic shock benefited from fludrocortisone–hydrocortisone, whereas participants without CAP did not.

Our recent retrospective target trial emulation found that fludrocortisone–hydrocortisone was associated with reduced in-hospital mortality in septic shock compared to hydrocortisone alone.

In this sub-sequent study, we assessed if steroid regimen comparative effectiveness was heterogeneous based on diagnosis of CAP.

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