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Adjunctive intravenous then oral vitamin C for moderate and severe community-acquired pneumonia in hospitalized adults: feasibility of randomized controlled trial.
Chambers, Stephen T; Storer, Malina; Scott-Thomas, Amy; Slow, Sandy; Williman, Jonathan; Epton, Michael; Murdoch, David R; Metcalf, Sarah; Carr, Anitra; Isenman, Heather; Maze, Michael.
Afiliación
  • Chambers ST; Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand. steve.chambers@otago.ac.nz.
  • Storer M; Canterbury Respiratory Research Group, Canterbury District Health Board, Christchurch, New Zealand.
  • Scott-Thomas A; Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
  • Slow S; Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
  • Williman J; Department of Agricultural Sciences, Lincoln University, Lincoln, New Zealand.
  • Epton M; Biostatistics and Computation Biology Unit, University of Otago, Christchurch, New Zealand.
  • Murdoch DR; Canterbury Respiratory Research Group, Canterbury District Health Board, Christchurch, New Zealand.
  • Metcalf S; Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
  • Carr A; Department of Infectious Diseases, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.
  • Isenman H; Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
  • Maze M; Department of Infectious Diseases, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.
Sci Rep ; 13(1): 11879, 2023 07 23.
Article en En | MEDLINE | ID: mdl-37482552
Patients hospitalised with community acquired pneumonia (CAP) have low peripheral blood vitamin C concentrations and limited antioxidant capacity. The feasibility of a trial of vitamin C supplementation to improve patient outcomes was assessed. Participants with moderate and severe CAP (CURB-65 ≥ 2) on intravenous antimicrobial treatment were randomised to either intravenous vitamin C (2.5 g 8 hourly) or placebo before switching to oral intervention (1 g tds) for 7 days when they were prescribed oral antimicrobial therapy. Of 344 patients screened 75 (22%) were randomised and analysed. The median age was 76 years, and 43 (57%) were male. In each group, one serious adverse event that was potentially intervention related occurred, and one subject discontinued treatment. Vitamin C concentrations were 226 µmol/L in the vitamin C group and 19 µmol/L in the placebo group (p < 0.001) after 3 intravneous doses. There were no signficant differences between the vitamin C and placebo groups for death within 28 days (0 vs. 2; p = 0.49), median length of stay (69 vs. 121 h; p = 0.07), time to clinical stability (22 vs. 49 h; p = 0.08), or readmission within 30 days (1 vs. 4; p = 0.22). The vitamin C doses given were safe, well tolerated and saturating. A randomised controlled trial to assess the efficacy of vitamin C in patients with CAP would require 932 participants (CURB-65 ≥ 2) to observe a difference in mortality and 200 participants to observe a difference with a composite endpoint such as mortality plus discharge after 7 days in hospital. These studies are feasible in a multicentre setting.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Ácido Ascórbico Tipo de estudio: Clinical_trials Límite: Adult / Aged / Female / Humans / Male Idioma: En Revista: Sci Rep Año: 2023 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Ácido Ascórbico Tipo de estudio: Clinical_trials Límite: Adult / Aged / Female / Humans / Male Idioma: En Revista: Sci Rep Año: 2023 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Reino Unido