Vitamin D supplementation for treatment and prevention of pneumonia in under-five children: A randomized double-blind placebo controlled trial

Abstract

There is no robust evidence of a definite biological benefit, either for therapy or prevention, to suggest a routine megadose supplement of vitamin D3 for under-five children with severe pneumonia.

Vitamin D and its role in the management and prevention of lower respiratory tract infections in infants and young children

“…Peak concentrations of 25(OH)D were found 3 days after bolus administration, which is longer than the time taken for resolution of the clinical features of severe pneumonia (median approximately 30 hours). The findings of Gupta, et al [5] are in keeping with two other studies which reported a lack of a therapeutic effect of acute vitamin D supplementation on the rate of resolution of acute pneumonia [7]. The second aspect of the study by Gupta, et al [5] was to assess the effect of vitamin D supplementation on the incidence of recurrence of pneumonia over six months.…”

“…The findings of Gupta, et al [5] are in keeping with two other studies which reported a lack of a therapeutic effect of acute vitamin D supplementation on the rate of resolution of acute pneumonia [7]. The second aspect of the study by Gupta, et al [5] was to assess the effect of vitamin D supplementation on the incidence of recurrence of pneumonia over six months. Once again, no effect was noted, but it is possible that the bolus of vitamin D was not given frequently enough to maintain vitamin D sufficiency, as the difference in 25(OH)D in the treatment group between admission and 3 months had fallen to only 7 ng/mL compared to 30 ng/mL at two weeks.…”

“…25(OH)D concentrations were not measured at 6 months after administration, but it is likely that the placebo and study groups would have had very similar levels. As mentioned by Gupta, et al [5], these results are at variance with those reported from Kabul [8], where recurrence of pneumonia was reduced for three months following administration of 100,000 IU vitamin D. It is of interest to note that the same authors in another study conducted in VOLUME 53 __ NOVEMBER 15, 2016 EDITORIAL Kabul were unable to show an effect of chronic vitamin D supplementation (100,000 IU vitamin D three monthly) on the incidence of the first episode of pneumonia in infants and young children [9].…”

“…In a randomized controlled trial published in this issue of Indian Pediatrics, Gupta and colleagues [5] were unable to show a convincing evidence of positive biological effects of vitamin D supplementation on either the response of severe pneumonia to treatment or the prevention of recurrence over a six month period in under-five children. Before one discards a possible positive effect of vitamin D status on the response to therapy for severe pneumonia in young children, it must be appreciated that in the present study vitamin D supplementation only began at the time of the child's hospitalization with pneumonia; thus there was little time for supplementation to have an effect on vitamin D status and thus on the enhancement of the speed of resolution of the pneumonia.…”

Vitamin D as an adjunct for acute community-acquired pneumonia among infants and children: systematic review and meta-analysis

“…The completed trials were from India [23] [24] and Afghanistan [25] . These trials enrolled children of different age groups, severity of pneumonia, and varied in terms of the dosage and duration of vitamin D supplementation.…”