A randomized controlled trial of zinc as adjuvant therapy for severe pneumonia in young children
Sudha Basnet1, Prakash S Shrestha, Arun Sharma
1Child Health Department, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Insights
Zinc supplementation did not significantly speed recovery or reduce treatment failure in children hospitalized with severe pneumonia. Further research is needed to confirm any marginal benefits of zinc for pneumonia treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Diarrhea and pneumonia are leading causes of mortality in children under five.
- Zinc supplementation effectively treats diarrhea and can prevent pneumonia.
Purpose of the Study:
- To evaluate the efficacy of zinc as an adjunct therapy for severe pneumonia in hospitalized children.
- To determine if zinc supplementation impacts recovery time and treatment failure rates.
Main Methods:
- 610 children (2-35 months) with severe pneumonia were enrolled.
- Participants received standard antibiotics and were randomized to zinc (10-20 mg daily) or placebo for 14 days.
- Primary outcome: time to cessation of severe pneumonia.
Main Results:
- Zinc supplementation showed a marginal, non-statistically significant faster recovery time (HR=1.10, 95% CI 0.94-1.30).
- The risk of treatment failure was slightly, but not significantly, lower in the zinc group (RR=0.88, 95% CI 0.71-1.10).
Conclusions:
- Adjunct zinc treatment provided only marginal benefits for time to recovery and treatment failure in hospitalized children with severe pneumonia.
- The findings suggest zinc may not be a highly effective standalone treatment for severe pneumonia in this population.
Background And Objective:
Diarrhea and pneumonia are the leading causes of illness and death in children <5 years of age. Zinc supplementation is effective for treatment of acute diarrhea and can prevent pneumonia. In this trial, we measured the efficacy of zinc when given to children hospitalized and treated with antibiotics for severe pneumonia.
Methods:
We enrolled 610 children aged 2 to 35 months who presented with severe pneumonia defined by the World Health Organization as cough and/or difficult breathing combined with lower chest indrawing. All children received standard antibiotic treatment and were randomized to receive zinc (10 mg in 2- to 11-month-olds and 20 mg in older children) or placebo daily for up to 14 days. The primary outcome was time to cessation of severe pneumonia.
Results:
Zinc recipients recovered marginally faster, but this difference was not statistically significant (hazard ratio = 1.10, 95% CI 0.94-1.30). Similarly, the risk of treatment failure was slightly but not significantly lower in those who received zinc (risk ratio = 0.88 95% CI 0.71-1.10).
Conclusions:
Adjunct treatment with zinc reduced the time to cessation of severe pneumonia and the risk of treatment failure only marginally, if at all, in hospitalized children.
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