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03 July 2017


A new study suggests that a combination of vitamin C, corticosteroids, and thiamine - vitamin B - can help prevent progressive organ failure caused by sepsis.

The mixture was tested by Dr Paul Marik, of Eastern Virginia Medical School, USA, and colleagues. They recruited 94 patients who received either this mixture or placebo, at random, given intravenously over seven months.

In-hospital mortality was 8.5% in the treatment group and very much higher, at 40.4%, in the control group. A score based on sepsis-related organ failure was improved for all patients in the treatment group, in which none developed progressive organ failure. In the treatment group, all patients were weaned off vasopressors significantly sooner than in the control group.

Details appeared on Monday (26 June) in the journal Chest.

The authors write: 'The global burden of sepsis is estimated as 15 to 19 million cases annually, with a mortality rate approaching 60% in low-income countries.

They conclude: 'Our results suggest that the early use of intravenous vitamin C, together with corticosteroids and thiamine, are effective in preventing progressive organ dysfunction, including acute kidney injury, and in reducing the mortality of patients with severe sepsis and septic shock.'

But they add that further studies are needed to confirm these preliminary findings.

Dr Marik commented: 'New therapeutic approaches to sepsis are desperately required. We did not test an expensive, proprietary designer molecule, but rather a combination of three cheap and readily available agents with a long safety record in clinical use since 1949.

'Due to its inherent safety, we believe that this treatment strategy can be adopted pending the results of further clinical trials. This inexpensive intervention has the potential to reduce the global mortality for sepsis.'

Source: Marik, P. E. et al. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest 26 June 2017; doi: 10.1016/j.chest.2016.11.036

Link: http://www.sciencedirect.com/science/article/pii/S0012369216625643

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