Vit C, Thiamine and Hydrocortisone in Sepsis : New trial needed

Paul Marik et el published a “retrospective before after ” study in Chest, Dec, 2016 about use of combination of parenteral Vit C, Thiamine and Hydrocortisone in sepsis and reported a mortality of 8.5% in treatment group compared with 40.4% in control group(p =<0.001).

Results are astonishing if you believe in the study.

There are several problems with the study.

  1. Retrospective
  2. Before after
  3. Why use combination of three ? Does combination work better than individual meds ? Is there a synergistic effect ?
  4. Single center
  5. Less number of patients
  6. Potential bias by investigators

Bottom Line

We need multi center randomized placebo controlled trial to really assess the claim.