Treatment of respiratory syncytial virus infection with vitamin A: a randomized, placebo-controlled trial in Santiago, Chile.
BACKGROUND
Treatment with high dose vitamin A reduces complications and duration of hospitalization for children with measles. In respiratory syncytial virus (RSV) infection, as with measles, low serum vitamin A concentrations correlate with increased severity of illness.


METHODS
To determine whether high dose vitamin A treatment is also effective for treating RSV disease, we conducted a randomized, double blind, placebo-controlled trial among 180 RSV-infected children between 1 month and 6 years of age at three hospitals in Santiago, Chile. Children with nasal washes positive for RSV antigen were given oral vitamin A (50,000 to 200,000 IU of retinyl palmitate, doses according to age; n = 89) or placebo (n = 91) within 2 days of admission.


RESULTS
There was no significant benefit from vitamin A treatment for the overall group in duration of hospitalization, need for supplemental oxygen or time to resolve hypoxemia. For the subgroup of children with significant hypoxemia on admission (room air oxygen saturation level < or = 90%), those given vitamin A had more rapid resolution of tachypnea (P = 0.01) and a shorter duration of hospitalization (5.5 vs. 9.3 days, P = 0.09). No toxicities were seen, including excess vomiting or bulging fontanel.


CONCLUSIONS
If vitamin A has a beneficial effect on the course of RSV disease, it may be seen only in more severely ill children.
Dowell
S F
SF
Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, GA 30333, USA. sfd2@ciddbd1.em.cdc.gov
Papic
Z
Z
Bresee
J S
JS
Larrañaga
C
C
Mendez
M
M
Sowell
A L
AL
Gary
H E
HE
Anderson
L J
LJ
Avendaño
L F
LF
D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*; D014801:Vitamin A / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*
D014801:Vitamin A