Sepsis is a disorder that has been recognised since Hippocratic times; medical students learn about it and most physicians would recognise it at the bedside, particularly when fully developed in a patient with septic shock. However, in the past few months, drotrecogin alfa (a human recombinant activated protein C), the only licensed product specifically indicated for the treatment of sepsis, has been withdrawn by the manufacturer because of a failure to confirm the first positive efficacy study. 1 A phase 3 clinical trial2 of Toll-like receptor 4 blocker eritoran did not achieve the primary efficacy endpoint, and a phase 2–3 study of talactoferrin (a human recombinant lactoferrin) was stopped because of toxic effects. Although the treatment of sepsis has clearly improved in the past decade, no specific treatment exists for a disorder with a case mortality of more than 20%. The dismal state of treatment for sepsis raises two important questions: first, despite more than a decade