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Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia
C B Stephensen1, L M Franchi, H Hernandez
1Department of International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Insights
High-dose vitamin A supplements did not improve pneumonia recovery in children and may cause adverse effects. Vitamin A should only be used if deficiency or measles is present.
Area of Science:
- Pediatrics
- Nutritional Science
- Infectious Diseases
Background:
- Community-acquired pneumonia is a leading cause of child mortality globally.
- Vitamin A plays a crucial role in immune function.
- The therapeutic potential of high-dose vitamin A in pneumonia recovery is under investigation.
Purpose of the Study:
- To evaluate the efficacy of high-dose vitamin A supplementation in enhancing the recovery of hospitalized children with community-acquired pneumonia.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- 95 children aged 3 months to 10 years with community-acquired pneumonia participated.
- Children received high-dose vitamin A or placebo, with dosages varying by age.
Main Results:
- Vitamin A group showed lower blood oxygen saturation and higher rates of retractions and consolidation.
- Children receiving vitamin A were more likely to require supplemental oxygen.
- No significant differences were observed in hospitalization duration or chest x-ray findings; no toxicity was reported.
Conclusions:
- High-dose vitamin A supplementation demonstrated modest adverse effects in children recovering from pneumonia.
- Therapeutic use of high-dose vitamin A is not recommended for pneumonia unless vitamin A deficiency or measles is present.
Objective:
To test the hypothesis that high-dose vitamin A supplements will enhance recovery of children hospitalized for the treatment of community-acquired pneumonia.
Design:
We conducted a randomized, double-blind, placebo-controlled clinical trial of high-dose vitamin A supplements among children 3 months to 10 years of age (N = 95) admitted to hospital with community-acquired pneumonia in Lima, Peru. Children 1 year of age received 200 000 IU on admission and 100 000 IU the next day.
Results:
Children receiving vitamin A (n = 48) had lower blood oxygen saturation (the mean difference on day 3 in hospital was 1.1%), higher prevalence rates of retractions (37% in the vitamin A group vs 15% in the placebo group on day 3), auscultatory evidence of consolidation (28% in the vitamin A group vs 17% in the placebo group on day 3), and were more likely to require supplemental oxygen (21% in the vitamin A group vs 8% in the placebo group on day 3) than children in the placebo group (n = 47). Adjustment for baseline severity of disease and nutritional status did not alter the association of vitamin A with increased clinical severity, although the difference in blood oxygen saturation was no longer statistically significant. No differences were seen in duration of hospitalization or in chest x-ray changes 14 days after admission. No deaths occurred, and toxicity of vitamin A was not seen.
Conclusions:
This study indicates that high-dose vitamin A supplements cause modest adverse effects in children recovering from pneumonia and should not be used therapeutically in such patients unless there is clinical evidence of vitamin A deficiency or concurrent measles infection.