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Open AccessArticle

Vitamin C, Hydrocortisone, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Analysis of Real-World Application

1
Department of Pharmacy, HonorHealth John C. Lincoln Medical Center, 250 E. Dunlap Ave., Phoenix, AZ 85020, USA
2
Department of Pharmacy Practice, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, USA
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Department of Pharmacy, Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA 92354, USA
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Division of Pulmonary, Critical Care, Hyperbaric, Allergy and Sleep Medicine, Department of Medicine, Loma Linda University School of Medicine, 11234 Anderson St, Loma Linda, CA 92354, USA
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Department of Pharmacy Practice, Marshall B. Ketchum University College of Pharmacy, 2575 Yorba Linda Blvd., Fullerton, CA 92831, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(4), 478; https://doi.org/10.3390/jcm8040478
Received: 12 March 2019 / Revised: 2 April 2019 / Accepted: 4 April 2019 / Published: 9 April 2019
A recent study suggested mortality benefits using vitamin C, hydrocortisone, and thiamine combination therapy (triple therapy) in addition to standard care in patients with severe sepsis and septic shock. In order to further evaluate the effects of triple therapy in real-world clinical practice, we conducted a retrospective observational cohort study at an academic tertiary care hospital. A total of 94 patients (47 in triple therapy group and 47 in standard care group) were included in the analysis. Baseline characteristics in both groups were well-matched. No significant difference in the primary outcome, hospital mortality, was seen between triple therapy and standard care groups (40.4% vs. 40.4%; p = 1.000). In addition, there were no significant differences in secondary outcomes, including intensive care unit (ICU) mortality, requirement for renal replacement therapy for acute kidney injury, ICU length of stay, hospital length of stay, and time to vasopressor independence. When compared to standard care, triple therapy did not improve hospital or ICU mortality in patients with septic shock. A randomized controlled trial evaluating the effects of triple therapy is necessary prior to implementing vitamin C, hydrocortisone, and thiamine combination therapy as a standard of care in patients with septic shock. View Full-Text
Keywords: sepsis; septic shock; vitamin C; hydrocortisone; thiamine sepsis; septic shock; vitamin C; hydrocortisone; thiamine
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Litwak, J.J.; Cho, N.; Nguyen, H.B.; Moussavi, K.; Bushell, T. Vitamin C, Hydrocortisone, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Analysis of Real-World Application. J. Clin. Med. 2019, 8, 478.

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