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

Abstract

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. Design: Children, aged 2-59 mo, with pneumonia and weight-forage <50th percentile who had been admitted to the Baca Ortiz Children's Hospital in Quito, Ecuador, were randomly assigned to receive'50 000 IU (aged 2-12 mo) or 100 000IU (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 (β = -3.57, SE = 1.09, P = 0.001). Duration of clinical signs was less in children with basal serum retinol concentrations ± 200 μ-g/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. © 2005 American Society for Nutrition.