Introduction: Drotrecogin alpha (activated) a recombinant form of human activated protein C (APC) has been considered as the first therapeutic intervention reducing all-cause mortality in severe sepsis, however its use in Europe is still limited. The Czech Republic was the first country in Europe, where APC was used in clinical practice. The aim of the study was to present initial experience with APC therapy in the Czech Republic and to describe a cohort of patients treated with APC in 2002. Material and methods: A retrospective, descriptive study based on medical records of all patients having received APC was conducted. Age, sex, diagnosis, Apache II score at the time of admission,number of failed organs, timing APC therapy (days after ICU admission) and clinical outcome were evaluated. Numerical data are presented as mean (SD) or median (25–75 %). Results: A total of 12 patients (M = 8, F = 4) were treated with drotrecogin alpha (activated) during the evaluated period; the mean age was 46 (20), median 54 (26–66) years. The mean value of Apache II score was 27 (6.5), median 25 (23–31) points. The number of failed organs before treatment with APC was 3.5 (1), median 4 (2–4). The mean time before drotrecogin alpha (activated)wasadministered was 3 (5),median 1 (1–2) days.Seven patients of 12 survived (58 %), six of them were discharged from hospital. Conclusion: Drotrecogin alpha (activated) is an important part of therapy in selected cases, current experience showing promising results so far, however more experience and probably more studies are needed to select the right patients who may benefit from this expensive therapy and also reimbursement issues must be defined. The Czech Society of Anaesthesiology and Intensive Care Medicine developed its own extended guidelines and recommendations for using this therapy in the Czech Republic.

        Key words: severe sepsis – therapy – activated protein C