May 21, 2004 Treating young children with zinc in addition to standard antibiotics greatly reduces the duration of severe pneumonia, according to a study by researchers from the Johns Hopkins Bloomberg School of Public Health and the International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research (ICDDR, B). Pneumonia is a leading cause of illness and death among children under age 5, particularly in the developing world. The researchers believe zinc therapy could help reduce antimicrobial resistance by decreasing the exposure to multiple antibiotics and lessen the health complications and deaths worldwide caused by severe pneumonia. The study appears in the May 22, 2004, edition of The Lancet.
"Our study shows that adding zinc to the standard antibiotic treatment significantly reduces the recovery time and overall hospital stay of children with severe pneumonia," said lead author W. Abdullah Brooks, MD, MPH, an assistant scientist in the Bloomberg School's Department of International Health and a researcher with the ICDDR, B. "The children who received zinc were also less likely to need a change in the antibiotic being used. This could have significant implications for reducing antibiotic-resistant infections by decreasing antibiotic exposure," he said.
Dr. Brooks and his colleagues conducted a double-blinded, placebo-controlled trial with 270 children who were being treated for severe pneumonia at a hospital in Bangladesh. The children, all aged 2 months to 23 months, were randomly selected to receive either a 20mg dose of zinc daily or a placebo in addition to the standard antibiotic treatment for pneumonia.
The results showed that of the children who received zinc had a shorter duration of severe pneumonia symptoms and signs compared to children who received the placebo. These included indrawing of the chest when breathing, severely raised respiration rates and low oxygen concentration in the blood. Zinc therapy also reduced the duration of severe pneumonia and overall hospital stay by an average of one day. However, the zinc did not affect the overall length of hospital stay or the duration of severe pneumonia of children with wheezing. Only two children in the study's zinc group had failure of treatment with the initial standard antibiotics compared to 11 in the placebo group.
"The zinc supplement was safe and substantially reduced the effects of acute pneumonia in young children. It could be especially beneficial in the developing world where millions of children die from pneumonia each year and where second line antibiotics may not be available," said senior investigator, Robert Black, MD, professor and chair of the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.
The authors of "Zinc for severe pneumonia in very young children: double-blind placebo-controlled trial" include, W.A. Brooks, M. Yunus, M.A. Wahed, K. Nahar and S. Yeasmin of the International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research. W.A. Brooks, M. Santosham and R. Black are with Department of International Health at the Johns Hopkins Bloomberg School of Public Health.
The study was funded by the Johns Hopkins Family Health and Child Survival Cooperative Agreement with the United Stated Agency for International Development and the International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research
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For information on the International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, visit http://www.icddrb.org.
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