Efficacy of zinc as adjuvant therapy for pneumonia in children less than five years

ABSTRACT

Pneumonia is the leading cause of morbidity and mortality in children < 5 years old. Zinc administration lowers the risk of acute lower respiratory infections in children. This study evaluated the efficacy of zinc supplementation in the treatment of pneumonia in Egyptian children aged < 5 years who were diagnosed and treated according to WHO guidelines. In a double-blind, placebo-controlled clinical trial, children with pneumonia or severe pneumonia were randomly assigned to receive zinc [n= 56] or placebo [n =56] daily till recovery and discharge from hospital as an adjuvant to antibiotics. The outcome variables were the duration of fast breathing, chest indrawing if present and fever. The following investigations were performed complete blood picture, serum zinc. Pneumonia was diagnosed in 16 and 15 cases in zinc and placebo group respectively while severe pneumonia was present in 40 cases in zinc group and 41 in placebo group. At enrollment both groups had deficient serum zinc level. Zinc group had shorter duration of rapid breathing [45.7 +/- 1.1 vs 66.9 +/- 1.3 h], chest indrawing [26.9 +/- 1.2 vs 44.3 +/- L4 h] and fever [23.0 +/- 1.2 vs 32.8 +/- 1.1 h] and the differences between zinc and placebo groups were statistically significant [P=0.000 for each of them]. At discharge both groups had higher serum zinc concentrations than at baseline 88.8 +/- 1.9 microg/dl for zinc and 75.3 +/- 1.1 microg/dl for placebo group. The difference between the zinc and placebo groups' discharge zinc concentrations was significant [P=0-000]. It is concluded that the use of zinc as adjuvant therapy for pneumonia or severe pneumonia in children < 5 years reduces the duration of rapid breathing, chest indrawing and fever. This study needs to be replicated in other populations, including those with and without a high prevalence of zinc deficiency