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Therapeutic effect of vitamin D in acute lower respiratory infection: A randomized controlled trial
Sanjana H Somnath1, Niranjan Biswal1, Venkatesh Chandrasekaran1
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Pondicherry 605006, India.
Insights
A single high dose of vitamin D3 did not improve outcomes for hospitalized children with acute lower respiratory infection (ALRI). However, it did effectively raise vitamin D levels within 72 hours.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Acute lower respiratory infection (ALRI) is a leading cause of childhood morbidity and mortality globally.
- Vitamin D deficiency is prevalent in children and may impact immune function and infection susceptibility.
Purpose of the Study:
- To evaluate the efficacy of a single high oral dose of vitamin D3 in improving outcomes for hospitalized children with ALRI.
- To assess the impact of vitamin D supplementation on hospital stay duration, mortality, and complication rates.
Main Methods:
- An open-label, parallel-group randomized trial involving 154 children aged 2 months to 5 years with ALRI.
- Participants received either standard care alone or standard care plus a single 100,000 IU oral dose of vitamin D3.
- Primary outcome was duration of hospital stay; secondary outcomes included mortality, complications, PICU admission, and recurrence of infections.
Main Results:
- No statistically significant difference was observed in the median duration of hospital stay between the vitamin D supplemented group and the standard care group.
- Secondary outcomes, including mortality, PICU admissions, complications, and 90-day infection recurrence, also showed no significant differences between the groups.
- Serum 25(OH)D levels were significantly increased within 72 hours in the vitamin D supplemented group, indicating achievement of sufficiency.
Conclusions:
- A single oral dose of 100,000 IU vitamin D3 did not reduce hospital stay, mortality, or complications in hospitalized children with ALRI.
- Vitamin D supplementation effectively achieved vitamin D sufficiency within 72 hours in the supplemented group.
- Further research may be needed to explore optimal dosing or different therapeutic strategies involving vitamin D for ALRI management.
Objectives:
To study the effect of vitamin D supplementation on the outcome of acute lower respiratory infection in hospitalized children.
Study Design:
This is an open label parallel group randomized trial. Total of 154 children aged 2 mo-5 yrs (mean age 13 mo) admitted with acute lower respiratory infection (ALRI) were randomized to receive standard care therapy alone or standard care therapy for the respiratory infection along with a single oral dose of 100,000 IU of vitamin D3. Serum 25(OH)D levels were measured at admission in all the children and 72 h after administration of vitamin D in the supplemented group. Primary outcome measured was the duration of hospital stay. Secondary outcomes measured were mortality, incidence of complications, admission to PICU and recurrence of respiratory infections within 90 days of discharge. Primary outcome was compared using Mann Whitney U test and secondary outcomes were compared using chi-square or Fischer's exact test.
Results:
Baseline characteristics were comparable between the two groups. There was no statistically significant difference in the primary outcome (Median duration of hospital stay in both the groups) and also in secondary outcomes (mortality, PICU admission, complications and recurrence of respiratory infections within 90 days of discharge).
Conclusion:
Single oral dose of 100,000 IU of vitamin D3 did not lead to reduction in duration of hospital stay, mortality, PICU admission or complications related to ALRI when compared to standard therapy alone in under five children hospitalized with ALRI but was able to achieve serum vitamin D sufficiency within 72 h of administration. Registered under clinical trial Registry of India Identifier no: CTRI/2014/09/005032.
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