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January 17, 2020

Lack of Benefit of High-Dose Vitamin C, Thiamine, and Hydrocortisone Combination for Patients With Sepsis

Author Affiliations
  • 1Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha
JAMA. 2020;323(5):419-420. doi:10.1001/jama.2019.22438

The use of vitamin C for treatment of patients with sepsis has generated substantial interest and controversy. In 2017, a single-center observational study suggested that the combination of high-dose vitamin C, thiamine, and hydrocortisone in conjunction with usual care was associated with reduced mortality (8.5% for combination treatment vs 40.4% for control).1 Despite the small sample size (94 patients), lack of concurrent controls and randomization, and important baseline imbalances between study groups, the study garnered significant attention. There were reports that some physicians were keen to adopt the strategy as part of routine practice, even though this approach had not been tested in a rigorous clinical trial.

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