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12-03-2012 | General practice | Article

Zinc unlikely to hasten pneumonia recovery in children

Abstract

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MedWire News: Adding zinc to standard therapy has little effect on speed of recovery or treatment failure risk among children with severe pneumonia, researchers report.

Although previous studies have shown that zinc therapy can prevent pneumonia development, the benefit of adjuvant zinc therapy in children hospitalized with pneumonia has been less clear, remark Tor Strand, from Innlandet Hospital Trust in Lillehammer, Norway, and co-investigators.

With this in mind, Strand et al conducted a study based in Nepal that involved 580 children aged 2-35 months. All were hospitalized with severe pneumonia, defined by the World Health Organization (WHO) as the presence of cough and/or breathing difficulty plus lower chest in-drawing on breathing.

Intravenous antibiotic therapy (benzylpenicillin 50,000 U/kg every 6 hours plus gentamicin 7.5 mg/kg once daily) was administered to all children in addition to zinc (10 mg in 2-11 month olds or 20 mg in children aged >11 months; n=288) or placebo (n=292) for up to 14 days.

As reported in Pediatrics, the researchers assessed how long each child took to recover and found that those treated with zinc recovered slightly quicker than zinc-free patients.

Risk for treatment failure, defined as a need for change in antibiotics, development of complications, such as pneumothorax or empyema, or admission to intensive care, was 12% lower with than without zinc therapy. However, this finding was nonsignificant, even after adjustment for potential confounders, including age and breastfeeding status.

There was no effect in subgroups including children with fever, hypoxia, wheezing, or virus positivity, except for the subgroup of children with endpoint consolidation (n=126), who recovered slightly but significantly faster than those without (n=394).

The proportions of children with severe pneumonia at 72, 96, and 120 hours after admission were slightly lower in the zinc than placebo groups, but again these differences were not significant.

Strand and colleagues highlight that the administration of optimal antibiotic therapy may have limited the size of the effect obtained from zinc therapy.

They conclude that this is "an aspect that needs to be taken into account when the results from this trial as well as those of other completed, ongoing, and planned studies are interpreted and summarized to determine the role of zinc in the treatment of severe pneumonia."

By Lauretta Ihonor

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