Critical care medicine specialist Paul Marik, MD, has described himself as a status quo destabilizer, and probably nothing illustrates that designation better than the sepsis treatment known as the Marik protocol.

In the past 3.5 years, Marik says, more than 1,300 patients have received his eponymous therapy (a combination of intravenous high-dose vitamin C, corticosteroids, and thiamine) at Sentara Norfolk General Hospital in Virginia, where he oversees the general intensive care unit (ICU).

In fact, Marik said, every patient with sepsis who comes to his hospital gets the cocktail, commonly referred to as HAT (hydrocortisone, ascorbic acid, and thiamine), along with their first antibiotic dose.

The retrospective study published in Chest compared hospital survival among 47 patients with sepsis before he developed his protocol vs survival among 47 patients who were treated with it. In the before group, 19 patients died. In the after group—all treated with Marik’s cocktail—only 4 died, but from complications unrelated to sepsis.

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