Vitamin C, hydrocortisone, and thiamine Combo reduces mortality in Severe Pneumonia

Combo therapy with vitamin C, hydrocortisone, and thiamine may benefit patients with severe pneumonia, according to a study published in the Journal of Critical Care.

Kim WY and his associates conducted a study to evaluate the efficacy of combined vitamin C, hydrocortisone, and thiamine in patients with severe pneumonia.

The investigators did a retrospective cohort study which consisted of critically ill adult patients with severe pneumonia who were admitted to the medical ICU. The treatment group contained patients with adjunct treatment with vitamin C, hydrocortisone, and thiamine and the patients who were not treated with the vitamin C protocol formed the control group.

Exclusion criteria included patients who were not admitted to ICU and/or required conventional oxygen therapy only, had an acute diagnosis that was not severe pneumonia, the admission to the ICU occurred >48 h after hospitalization and the vitamin C protocol infusion that occurred >48 h after hospitalization.

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The primary study outcome was hospital mortality during the index hospitalization. Secondary outcomes were the number of vasopressor-free days at day 28, number of ventilator-free days at day 28, ICU length of stay, changes in the lactate.

Key findings:

• First, when the vitamin C protocol was added to the standard treatment for critically ill patients with severe pneumonia, hospital mortality tended to drop. In propensity score analysis, the vitamin C protocol was associated with significantly lower mortality.


• Second, the vitamin C protocol significantly improved the chest radiologic score on day 7, and this improvement associated independently with less hospital mortality.


• Third, the vitamin C protocol did not associate with increased rates of AKI or superinfection.

The study concluded that the results indicate that the combined use of vitamin C, hydrocortisone, and thiamine improves the chest radiologic findings of patients with severe pneumonia and tends to reduce their mortality.

For reference log on to https://doi.org/10.1016/j.jcrc.2018.07.004