title: Vitamin D3 Supplementation and Antibiotic Consumption - Results from a Prospective, Observational Study at an Immune-Deficiency Unit in Sweden.
abstract: BACKGROUND
  Vitamin D supplementation has been proposed to improve clinical symptoms during respiratory tract infections (RTIs), but results from randomized, placebo-controlled trials (RCT) are inconclusive. Previously, we performed an RCT in patients with various immune-disorders and observed that supplementation with 4000 IU vitamin D/day during 12 months significantly reduced antibiotic consumption and RTIs. This formed the basis for new guidelines at our unit; i.e. patients with insufficient levels of 25-hydroxyvitamin D (≤75 nmol/L) are now offered vitamin D supplementation. The aim of this prospective follow-up study was to evaluate the outcome of these new recommendations with regard to antibiotic consumption in our unit.
  
  
  METHODS
  277 patients with insufficiency were supplemented with vitamin D3, 1500-1600 IU/day for 12 months. Each patient was its own control and data on antibiotic consumption was monitored 12 months before and 12 months after initiation of vitamin D3 supplementation.
  
  
  RESULTS
  Vitamin D3 supplementation resulted in a significantly reduced antibiotic consumption, from 20 to 15 days/patient (p<0.05). The number of antibiotic-free patients increased from 52 to 81 after vitamin D3 supplementation; OR 1.79; 95% CI 1.20-2.66 (p<0.01). The number of antibiotic-prescriptions decreased significantly, a finding that mainly was attributed to a reduction of respiratory tract antibiotics (p<0.05). Subgroup analysis showed that only patients without immunoglobulin substitution (n = 135) had a significant effect of vitamin D supplementation.
  
  
  CONCLUSIONS
  Vitamin D3 supplementation of 1600 IE /day is safe to use in immunodeficient patients with 25-OHD levels less than 75 nmol/L and significantly reduced the antibiotic consumption in patients without immunoglobulin substitution.
authors.affiliation: Infectious Disease Clinic, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.|Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet, 141 86, Stockholm, Sweden.
authors.forename: Anna-Carin
authors.initials: AC
authors.lastname: Norlin
authors.affiliation: Infectious Disease Clinic, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Hansen
authors.affiliation: Infectious Disease Clinic, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.
authors.forename: Emilie
authors.initials: E
authors.lastname: Wahren-Borgström
authors.affiliation: Infectious Disease Clinic, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Granert
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, 141 86 Stockholm, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Björkhem-Bergman
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, 141 86 Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Bergman