Demonstration of the effectiveness of zinc in diarrhoea of children living in Switzerland.
We designed a double-blinded randomized clinical trial of zinc (10 or 20 mg of zinc sulphate for 2-5 month-old or 6-59 month-old children, respectively, during 10 days) vs. placebo in otherwise healthy children aged 2 months to 5 years who presented with acute diarrhoea (i.e. ≥3 stools/day for less than 72 h). Eighty-seven patients (median age 14 months; range 3.1-58.3) were analysed in an intention-to-treat approach. Forty-two patients took zinc and 45 placebo. There was no difference in the duration nor in the frequency of diarrhoea, but only 5% of the zinc group still had diarrhoea at 120 h of treatment compared to 20% in the placebo group (P = 0.05). Thirty-one patients (13 zinc and 18 placebo) were available for per-protocol analyses. The median (IQR) duration of diarrhoea in zinc-treated patients was 47.5 h (18.3-72) and differed significantly from the placebo group (median 76.3; IQR 52.8-137) (P = 0.03). The frequency of diarrhoea was also lower in the zinc group (P = 0.02).


CONCLUSIONS
zinc treatment decreases the frequency and severity of diarrhoea in children aged 2 months to 5 years living in Switzerland. However, the intention-to-treat analysis reveals compliance issues that question the proper duration of treatment and the choice of optimal pharmaceutical formulation.
Medico-Surgical Paediatric Department, Lausanne University Hospital, Lausanne, Switzerland, pierre-alex.crisinel@chuv.ch.
Pierre Alex
PA
Crisinel
Marie-Elise
ME
Verga
Konan Sallert Alexis
KS
Kouame
Anne
A
Pittet
Céline Gasser
CG
Rey-Bellet
Olivier
O
Fontaine
Ermindo Roberto
ER
Di Paolo
Mario
M
Gehri
D000208:Acute Disease; D002675:Child, Preschool; D003967:Diarrhea / Q000178:diet therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome; D017967:Zinc Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D019287:Zinc Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*
D017967:Zinc Compounds; D019287:Zinc Sulfate