Role of zinc in severe pneumonia: a randomized double bind placebo controlled study

Shah, Dutta, Shah Dheeraj, Mishra

Description

Pneumonia is a leading cause of morbidity and mortality in children. Objective The aim of study was to evaluate the efficacy of Zinc supplementation in treatment of severe pneumonia in hospitalized children. Design/Methods A double blind randomized, placebo- controlled clinical trial conducted at a tertiary care centre of a teaching hospital. Children with diagnosis of severe pneumonia were randomly assigned to receive supplementation with either elemental zinc or placebo by mouth at the time of enrollment. From day 2, they received 10 mg of their assigned treatment by mouth twice a day for 7 days along with standard antimicrobial therapy. Results The baseline characteristics like age, sex, weight, weight Z score, height, height Z score, weight for height Z score and hemoglobin were comparable in both study groups. The respiratory rate, chest indrawing, cyanosis, stridor, nasal flaring, wheeze and fever in both groups recorded at enrollment and parameters did not differ significantly between the two groups. The outcome measures like time taken for resolution of severe pneumonia, pneumonia, duration of hospital stay, nil per oral, intravenous fluid, oxygen use, treatment requiring 2 nd line of drug and 3 rd line drug were evaluated and found to be same. Conclusion The present study did not show a statistically significant reduction in duration of severe pneumonia, or reduction in hospital stay for children given daily zinc supplementation along with standard antimicrobial therapy. Therefore, zinc supplementation given during the acute episode does not help in short term clinical recovery from severe pneumonia.

Sujets

• Pneumonia
• Children
• Zinc

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 16
• Langue: English

Extrait

Shahet al. Italian Journal of Pediatrics2012,38:36 http://www.ijponline.net/content/38/1/36

ITALIAN JOURNAL OF PEDIATRICS

R E S E A R C HOpen Access Role of zinc in severe pneumonia: a randomized double bind placebo controlled study 1* 23 4 Gauri S Shah, Ashok K Dutta , Dheeraj Shahand Om P Mishra

Abstract Background:Pneumonia is a leading cause of morbidity and mortality in children. Objective:The aim of study was to evaluate the efficacy of Zinc supplementation in treatment of severe pneumonia in hospitalized children. Design/Methods:A double blind randomized, placebo controlled clinical trial conducted at a tertiary care centre of a teaching hospital. Children with diagnosis of severe pneumonia were randomly assigned to receive supplementation with either elemental zinc or placebo by mouth at the time of enrollment. From day 2, they received 10 mg of their assigned treatment by mouth twice a day for 7 days along with standard antimicrobial therapy. Results:The baseline characteristics like age, sex, weight, weight Z score, height, height Z score, weight for height Z score and hemoglobin were comparable in both study groups. The respiratory rate, chest indrawing, cyanosis, stridor, nasal flaring, wheeze and fever in both groups recorded at enrollment and parameters did not differ significantly between the two groups. The outcome measures like time taken for resolution of severe pneumonia, nd pneumonia, duration of hospital stay, nil per oral, intravenous fluid, oxygen use, treatment requiring 2line of drug rd and 3line drug were evaluated and found to be same. Conclusion:The present study did not show a statistically significant reduction in duration of severe pneumonia, or reduction in hospital stay for children given daily zinc supplementation along with standard antimicrobial therapy. Therefore, zinc supplementation given during the acute episode does not help in short term clinical recovery from severe pneumonia. Keywords:Pneumonia, Children, Zinc

Introduction Worldwide, pneumonia is the leading cause of pediatric morbidity and mortality. It is estimated that pneumonia is responsible for >2 million deaths each year in children below 5 years of age, and contributes 20% of the annual deaths in this age group [1]. Approximately 95% of the pneumoniarelated deaths occur in developing countries, and the younger age groups have the highest risk of death. Zinc supplementation lowers the risk of acute re spiratory illnesses and diarrhea in children [2]. A recent clinical trial conducted in Bangladesh suggested that zinc supplementation given with empiric antimicrobial

* Correspondence: [e-mail] 1 Department of Pediatrics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal Full list of author information is available at the end of the article

therapy can significantly shorten the duration of severe pneumonia, tachypnea, hypoxia, and chest indrawing and duration of hospital stay for young children with pneu monia [3]. However, therapeutic trials of Zn conducted in Indian hospitalized children with severe pneumonia demonstrated no overall effect [4,5]. ValentinerBranth et al. [6] demonstrated that Zn neither reduced the risk of treatment failure nor hasten the recovery of nonsevere or severe pneumonia in Nepalese children between 2–35 month of age. Many children in Nepal, especially below 5 years of age, are admitted with severe pneumonia in pediatric wards requiring antimicrobial therapy with prolonged hospital stay. In view of previous studies, which have evaluated the role of zinc in children with pneumonia either below 2 or 3 years of age with variable reports [3,6]. The present study was undertaken

© 2012 Shah et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.