Zinc supplementation effective in children with pneumonia

Nutrition Research Newsletter, Oct, 2004

Pneumonia is a leading cause of morbidity and mortality in children less than 5 years of age. More than 90% of these deaths occur in developing countries. Zinc prevents pneumonia and cures diarrhea. It can potentially act in the acute phase response to infection, helping to boost the body's immune response to infection. Therefore, children with good zinc status may have a more robust immune response than those with poor zinc status.

The aim of a recent study was to determine whether zinc, along with antibiotics, would improve the outcome of severe pneumonia. A double-blind, randomized, placebo controlled clinical trial in hospitalized children who were between 2 and 23 months old at the time of admission was performed. The subjects included 270 children who were either given 20 mg or elemental zinc per day, or placebo, in addition to the hospital's standard antimicrobial management, until discharge. The outcomes were time to cessation of severe pneumonia and discharge from the hospital. Discharge was allowed when respiratory rate was 40 per minute or less for 24 consecutive hours while patients were maintained only on oral antibiotics.

The group receiving zinc had reduced duration of severe pneumonia (relative hazard [RH] = .070, 95% CI 0.51-0.98), including duration of chest indrawing (0.80, 0.61-1.05), respiratory rate more than 50 per min (0.74, 0.57-0.98), and hypoxia (0.79, 0.61-1.04), and overall hospital duration (0.75, 0.57-0.99). The mean reduction is equivalent to 1 hospital day for both severe pneumonia and time in hospital. All effects were found to be greater when children with wheezing were omitted form the analysis.

It appears that adjuvant treatment with 20 mg zinc per day reduces recovery time from severe pneumonia in children, and may reduce antimicrobial resistance by decreasing multiple antibiotic exposures.

W. Brooks, M. Yunus, M. Santosham, et al. Zinc for severe pneumonia in very young children: double-blind placebo-controlled trial. The Lancet; 363:1683-1688 (May 22, 2004). [Correspondence: Dr W Abdullah Brooks, Programme of infectious diseases and vaccine sciences, Health Systems Infectious Diseases Divisions, International Centre for Diearrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, GPO Box 128, Mohakhali, Dhaka 1000, Bangladesh. E-mail: abrooks@icddrb.org].