Department of Pharmacology, Institute of Post Graduate Medical Education & Research, Kolkata, India.
Indian J Pediatr. 2011 Sep;78(9):1085-90. doi: 10.1007/s12098-011-0495-9. Epub 2011 Jun 10.
To evaluate the effectiveness and safety of zinc supplementation as adjuvant in treatment of pneumonia.
Ninety-eight children with acute bacterial pneumonia, aged between 2 months to 5 years, were studied in a randomized controlled single blind design. They received either zinc supplementation, as zinc acetate syrup, or placebo, as vitamin B-complex syrup, for 14 days, concomitantly with antimicrobial treatment (49 per group). Chest radiograph and blood tests were done for confirmation of diagnosis and severity of pneumonia was assessed by breathing rate, chest in-drawing and body temperature. Potentially immunosuppressed children or those with serious comorbidity were excluded. Follow-up was done daily while subjects were admitted (generally 7 days) and the final assessment made on the 14th day on out-patient basis.
Children enrolled in zinc and placebo groups were of comparable age [17 ± 10 and 10 ± 30 months (median ± interquartile range) respectively] and sex distribution [34 (69.4%) vs 31 (63.3%) males respectively]. Duration of illness at diagnosis was also comparable. Patients supplemented with zinc showed no difference in clinical cure rate at 14 days when compared with placebo. Fast breathing was present after 1 wk of treatment in 49% subjects in zinc supplemented vs 43% on placebo (p = 0.685). There was also no difference in breathing rate at study end. Regarding fever, the mean temperature was <99°F in both groups at study end. Hemoglobin, total leukocyte count, standard liver function tests and creatinine showed no difference between groups either at baseline or at study end. There were no treatment emergent adverse events attributable to zinc.
Though well tolerated; the addition of zinc does not improve symptom duration or cure rate in acute bacterial pneumonia in under-five children.
评估补锌作为辅助治疗肺炎的有效性和安全性。
采用随机对照单盲设计，纳入 98 例年龄在 2 个月至 5 岁之间的急性细菌性肺炎患儿，分别给予醋酸锌糖浆补锌或维生素 B 族复合糖浆安慰剂治疗，疗程均为 14 天，同时接受抗菌治疗（每组 49 例）。通过胸部 X 线和血液检查确诊，并根据呼吸频率、胸凹陷和体温评估肺炎的严重程度。排除潜在免疫抑制或严重合并症的患儿。患儿入院期间（一般为 7 天）每天随访，第 14 天门诊进行最终评估。
纳入锌组和安慰剂组的患儿年龄[17 ± 10 和 10 ± 30 个月（中位数 ± 四分位间距）]和性别分布[34（69.4%）比 31（63.3%）男性]相似。诊断时的疾病持续时间也相似。与安慰剂相比，补锌患儿在第 14 天的临床治愈率无差异。补锌组治疗 1 周后仍有 49%的患儿呼吸急促，而安慰剂组为 43%（p = 0.685）。研究结束时呼吸频率也无差异。关于发热，两组患儿研究结束时的平均体温均<99°F。血红蛋白、总白细胞计数、标准肝功能检查和肌酐在基线或研究结束时两组间均无差异。锌治疗无新发不良事件。
虽然锌的耐受性良好，但补锌并不能改善 5 岁以下儿童急性细菌性肺炎的症状持续时间或治愈率。
