الفهرس 
Comparative Clinical Study Between Triple Therapy Regimen to Hydrocortisone Monotherapy in Reducing the Mortality Rate in Septic Shock Patients
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Abstract
: This prospective, comparative and randomized clinical study assessed the effectiveness of triple therapy regimen (hydrocortisone, thiamine and vitamin C) versus hydrocortisone as a monotherapy in reducing the in hospital and ICU mortality and preventing progressive organ dysfunction in septic shock patients.
Methodology: Ninety-four patients were randomly assigned to one of two groups: the first arm received hydrocortisone 50 mg/6h intravenously for 7 days /or till intensive care unit discharge, if sooner, followed by tapering. The second group received hydrocortisone 50 mg/6h intravenously for 7 days or ICU discharge followed by tapering, vitamin C 1.5 g/6h intravenously for 4 days or till ICU discharge and thiamine 200 mg/12h intravenously for 4 days or till ICU discharge.
Results: The triple therapy regimen (Intervention arm) showed a non-significant reduction in 28 days’ mortality when compared to hydrocortisone monotherapy (17 [36.2%] vs. 21 [44.7%]; P = 0.4005), but it was significantly lower than the control group regarding duration of shock state and vasopressors (in days) (4.000 [3.000-7.000]; 5.000 [4.000-8.000], [P = 0.0100]). The patients in the hydrocortisone group were likely to get 0.59 mg/dl more in SCr level than those in the triple therapy group by a linear regression model which was significant (P < 0.05). Also, the number of patients who developed a fever after 216 hours was significantly higher in the control group (p value=0.0299).
Conclusion: The triple therapy regimen for septic shock management showed non-significant efficacy in decreasing 28 days’ mortality when compared to hydrocortisone monotherapy. On the other hand, it showed significant efficacy in decreasing the duration of shock state and decreasing in serum creatinine level by 0.59 mg/dl over hydrocortisone alone.