Effects of moderate doses of vitamin A as an adjunct to the treatment of pneumonia in underweight and normal-weight children: a randomized, double-blind, placebo-controlled trial.
BACKGROUND
Randomized controlled trials have shown inconsistent responses of childhood pneumonia to the use of vitamin A as an adjunct to the standard treatment of pneumonia.


OBJECTIVE
We evaluated the effect of a moderate dose of vitamin A as an adjunct to standard antimicrobial treatment on the duration of respiratory signs in children with pneumonia.


METHODS
Children, aged 2-59 mo, with pneumonia and weight-for-age <50th percentile who had been admitted to the Baca Ortíz Children's Hospital in Quito, Ecuador, were randomly assigned to receive 50,000 IU (aged 2-12 mo) or 100,000 IU (aged >12-59 mo) vitamin A or a placebo.


RESULTS
Of the 287 children enrolled, 145 received vitamin A and 142 received placebo. No overall differences were observed between the 2 groups in the duration of signs of pneumonia. Multiple linear regression showed a significant interaction between basal serum retinol concentration and vitamin A group for the time (in h) to remission of respiratory signs (beta = -3.57, SE = 1.09, P = 0.001). Duration of clinical signs was less in children with basal serum retinol concentrations >200 microg/L who received vitamin A supplements than in children with similar concentrations who received placebo (69.9 +/- 49.9 h compared with 131.3 +/- 143.9 h; P = 0.049).


CONCLUSIONS
Overall, we found no effect of a moderate dose of vitamin A supplementation on the duration of uncomplicated pneumonia in underweight or normal-weight children aged <5 y. However, a beneficial effect was seen in children with high basal serum retinol concentrations.
Rodríguez
Alicia
A
Corporación Ecuatoriana de Biotecnología, Quito, Ecuador.
Hamer
Davidson H
DH
Rivera
José
J
Acosta
Mario
M
Salgado
Gilda
G
Gordillo
Martha
M
Cabezas
Myryam
M
Naranjo-Pinto
Carlos
C
Leguísamo
Julio
J
Gómez
Dinor
D
Fuenmayor
Guillermo
G
Játiva
Edgar
E
Guamán
Gladys
G
Estrella
Bertha
B
Sempértegui
Fernando
F
D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D002675:Child, Preschool; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004484:Ecuador; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy; D013851:Thinness / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome; D014801:Vitamin A / Q000097:blood / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control; D014815:Vitamins / Q000097:blood / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D014815:Vitamins; D014801:Vitamin A