The Effect of Vitamin-D Supplementation in Severe Pneumonia Among Infants

Abstract
Background: Worldwide, acute lower respiratory tract infection (ALRTI) is a leading cause of mortality in children less than 5 years old, more than 90% are in developing countries. Pneumonia is the leading infectious cause of death in children, accounting for 18.3% of all deaths in children less than 5 years of age. Vitamin D is thought to have roles in the improvement of immune function and the reduction of inflammation and may reduce respiratory tract infection susceptibility in children. Vitamin D has an important influence on the host's immune system, modulating both innate and adaptive immunity and regulating the inflammatory cascade.
Aim of Study: We aimed to compare the duration and outcome of severe pneumonia of children in the two study groups receiving the standard therapy (appropriate antibiotic and other supportive therapy) with those receiving vitamin D3 supplementation in addition to the standard therapy. Our hypothesis is that vitamin D supplementation decreases the duration of resolution of severe pneumonia in children less than two years of age.
Patients and Methods: This was a double-blinded, rand-omized, placebo-controlled trial undertaken in the Children University Hospital, Assiut University during winter. Infants with severe pneumonia between the ages of 3 and 23 months are studied. Patients were randomized to receive vitamin D3 treatment (intervention group) or placebo (control group) to assess the clinical benefit of oral supplementation of vitamin D3, in addition to standard antibiotic and other supportive therapy, to hospitalized infants less than two years of either sex with severe pneumonia.
Results: The results of this small randomized controlled clinical trial indicate that short-term supplementation with vitamin D along with antibiotic treatment, significantly reduces the mean time taken for resolution of severe pneumonia (p<0.001) and the mean time taken for the improvement of oral feeding (p<0.05), in the intervention group receiving vitamin D 100IU/kg for at least 5 days from the first day of admission. Vitamin D supplementation was well tolerated in all patients without showing any side effects.