A Randomized Controlled Trial of Zinc as Adjuvant Therapy for Severe Pneumonia in Young Children
A Randomized Controlled Trial of Zinc as Adjuvant Therapy for Severe Pneumonia in Young Children
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DOI：
10.1542/peds.2010-3091
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发表时间：
2012-04-01
期刊：
影响因子：
8
通讯作者：
Strand, Tor A.
中科院分区：
文献类型：
--
作者：
Basnet, Sudha;Shrestha, Prakash S.;Strand, Tor A.
背景和目的：腹泻和肺炎是5岁以下儿童疾病和死亡的主要原因。补锌对治疗急性腹泻有效，可预防肺炎。在这项试验中，我们测量了锌的疗效时，给予儿童住院治疗和抗生素治疗重症pneumonia.METHODS：我们招募了610名儿童，年龄2至35个月的严重肺炎，世界卫生组织定义为咳嗽和/或呼吸困难结合下胸部内吸。所有儿童均接受标准抗生素治疗，并随机接受锌（2至11个月大的儿童10 mg，年龄较大的儿童20 mg）或安慰剂每日治疗长达14天。主要结果是时间停止严重pneumonia.Results：锌收件人恢复略快，但这种差异没有统计学意义（风险比= 1.10，95%CI 0.94-1.30）。同样，治疗失败的风险是轻微的，但不显着降低那些谁收到锌（风险比= 0.88 - 95%CI 0.71-1.10）。结论：辅助治疗与锌减少时间停止严重肺炎和治疗失败的风险只有轻微的，如果在所有，在住院儿童。儿科2012;129：701-708
BACKGROUND AND OBJECTIVE: Diarrhea and pneumonia are the leading causes of illness and death in children,5 years of age. Zinc supplementation is effective for treatment of acute diarrhea and can prevent pneumonia. In this trial, we measured the efficacy of zinc when given to children hospitalized and treated with antibiotics for severe pneumonia.METHODS: We enrolled 610 children aged 2 to 35 months who presented with severe pneumonia defined by the World Health Organization as cough and/or difficult breathing combined with lower chest indrawing. All children received standard antibiotic treatment and were randomized to receive zinc (10 mg in 2- to 11-month-olds and 20 mg in older children) or placebo daily for up to 14 days. The primary outcome was time to cessation of severe pneumonia.RESULTS: Zinc recipients recovered marginally faster, but this difference was not statistically significant (hazard ratio = 1.10, 95% CI 0.94-1.30). Similarly, the risk of treatment failure was slightly but not significantly lower in those who received zinc (risk ratio = 0.88 95% CI 0.71-1.10).CONCLUSIONS: Adjunct treatment with zinc reduced the time to cessation of severe pneumonia and the risk of treatment failure only marginally, if at all, in hospitalized children. Pediatrics 2012;129:701-708