Vitamin D supplement reduces pediatric AOM
By Kirsty Oswald, medwireNews Reporter
10 June 2013
Pediatr Infect Dis J 2013; Advance online publication

medwireNews: Research shows that children who are prone to acute otitis media (AOM) are at increased risk for recurrence if they have depleted levels of vitamin D.

And, when children achieved threshold serum concentrations of vitamin D through supplementation, the rate of uncomplicated AOM significantly decreased over the 4-month study, show findings in the Pediatric Infectious Disease Journal.

In the randomized trial, 58 children with a history of otitis media who received vitamin D 1000 IU daily for 4 winter months had mean serum levels that were significantly higher than in 58 children who received placebo, at 36.8 ng/mL versus 18.7 ng/mL. And, 44 (75.9%) children in the treatment group had a serum vitamin D level of 30 ng/mL or more, compared with just two (3.4%) children in the placebo group .

The researchers found that significantly fewer children in the vitamin D supplementation group experienced at least one AOM episode compared with the placebo group at 26 (44.8%) versus 38 (65.5%), or uncomplicated AOM at 10 (17.2%) versus 29 (50.0%).

Analysis showed that the risk for AOM was a significant 53% lower, and the risk for uncomplicated AOM 88% lower in the treatment group. However, there was no significant difference in the rate of complicated episodes.

Serum levels of vitamin D significantly correlated with the probability of uncomplicated AOM, but not complicated AOM or AOM alone. Children with levels of 30-39 ng/mL and greater than 40 ng/mL had an 81% and 95% reduced risk for uncomplicated AOM, respectively, compared with children whose levels were less than 12 ng/mL.

"This finding is in line with the view of many experts who, on the basis of a variety of health-related outcomes, have repeatedly indicated that 30 ng/mL is the minimum 25(OH)D level needed to avoid clinical problems related to [vitamin D] hypovitaminosis," comment authors Susanna Esposito (University of Milan, Italy) and colleagues.

Noting that in the placebo group, serum vitamin D concentrations fell significantly from just below this threshold at baseline in November, the authors say that systematic supplementation in the winter is needed, particularly in areas at high latitude or with high levels of air pollution.

They note that the costs of vitamin D supplementation may not outweigh those associated with treating an episode of AOM.

"However, in children with frequent AOM, particularly when other attempts to face the problem have failed, even the elimination of a single episode can be important not only for the child but also for the family, generally sorely tried by continuous febrile painful AOM episodes," they conclude.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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