Background and aims: Despite great advancement in treatment of sepsis, mortality of sepsis remains unacceptably high, even with the modern antibiotic and intensive care technologies. Considering the key role of immune dysfunction in sepsis pathophysiology, different treatments were evaluated, but failed to improve survival of patients. Natural remedies have been tested in various studies to overcome sepsis. In this study, we aim to review some of the evidence from clinical, In vitro and In vivo studies about the effect of alternative medicine on sepsis management.

Methods: The following databases were searched up to March 2014: PubMed, Scopus, Web of Science, Ovid and Google Scholar using combination of Mesh term. All in vitro and In Vivo studies also clinical trials published in English which evaluated alternative medicine in management of sepsis were included.

Results: Out of 95 relevant studies, the inclusion criteria were met for 78 cases. Among them 18 studies were performed on humans. The most herbal medicine including Xubijing (N=10), and then Rhubarb (n=3). Most of the reviewed botanical medicines modulate immune system. Reduction of mortality also reported in studies.

Conclusion: Modulation of immune system, anti-inflammatory activities and improvement of survival were the action of herbal medicine. A monovalent approach is not enough for treatment of sepsis, we recommend further studies to identifies active component of herbal and use them in combination. Also animal model of sepsis does not exactly mimic human sepsis, so more clinical studies should be performed. With no new drug on the horizon, herbal medicine will be promising for treatment of sepsis.