Stress-related adrenal insufficiency associated with polytrauma has been postulated as a factor in the development of hospital-acquired infections. This multicenter, randomized, double-blind, parallel, placebo-controlled study conducted in seven separate intensive care units (ICUs) in France from November 15, 2006 to August 4, 2009 was designed to test the idea that steroid treatment could reduce the prevalence of hospital-acquired pneumonia in trauma patients. All multiple-trauma patients, defined as having two or more traumatic injuries and injury severity score>15, aged>15 years who were expected to require mechanical ventilation for more than 48h, were included. All patients were tested for corticosteroid insufficiency with a corticotropin test. Upon completion of this test, patients w...