Two recent consensus statements6,7 developed by many expert panels (including the one Dr. Marik chaired) provided evidence-based guidelines for the use of corticosteroids in septic patients. Dr. Marik's opinions diverge from these guidelines, which are more conservative in nature regarding concerns surrounding harm. Thus, specific recommendations such as starting steroid therapy based on vasopressor dose and time from presentation, tapering, and longer duration of treatment (16 to 19 days) cannot be endorsed from current data. Steroid use in septic patients without shock is counter to one of the consensus guidelines.6 Dr. Marik acknowledged the need for careful infection surveillance to limit the complications of corticosteroid treatment, yet, arguably, the avoidance of drug treatment (or a more limited duration of treatment) would prove far more effective in nonproven indications. It is important to provide a balanced perspective to the debate and primum non nocere.