The management of sepsis has substantially improved over the past 15 years. In this study, early, goal-directed therapy, which focuses on the initial resuscitation efforts, was compared with usual care for the management of severe sepsis in the United Kingdom. The incidence of severe sepsis and septic shock in adults is estimated to range from 56 to 91 per 100,000 population per year. 1 Affected patients have high rates of death, complications, and resource utilization. 2 – 5 Since 2002, the Surviving Sepsis Campaign (SSC) has promoted best practice, including early recognition, source control, appropriate and timely antibiotic administration, and resuscitation with intravenous fluids and vasoactive drugs. 6 – 8 Resuscitation guidance is largely based on a 2001 single-center, proof-of-concept study by Rivers et al., which indicated that protocolized delivery of 6 hours of early, goal-directed therapy (EGDT) to patients presenting to the emergency department . . .