Comparing the effect of zinc gluconate and placebo in the treatment of tachypnea, dyspnea and fever in children aged 2 to 23 months with acute bronchiolitis
DOI:
https://doi.org/10.18203/2349-3259.ijct20201711Keywords:
Acute bronchiolitis, Zinc gluconate, InfantsAbstract
Background: Acute viral bronchiolitis is the most common infection of the lower respiratory tract in infants under 2 years and is one of the reasons for their admission all around the world. The aim of this study was comparing the effect of zinc gluconate and placebo in the treatment of tachypnea, dyspnea and fever in children aged 2 to 23 months with acute bronchiolitis.
Methods: This randomized clinical trial study has been done on 100 infants aged 2 to 32 months with the diagnosis of bronchiolitis who divided in two groups. 50 patients received zinc gluconate and 50 patients received placebo. The symptoms and sign of the disease at baseline and then at 24, 72, and 7 days after starting treatment and duration of hospitalization were compared between the two groups.
Results: The treatment and placebo groups were similar in respect to mean age and gender distribution. Two groups were similar in terms of clinical symptoms and signs at the time of admission. Bronchiolitis recovery was better in the treatment group than in the placebo group. This positive effect was statistically significant for vising (p=0.023) and rhinorrhea (p=0.027) at 72 hours after starting treatment. The mean duration of hospitalization was significantly less in the treatment group than in the placebo group (4.14±1.21 versus 4.64±1.2 days; p=0.016).
Conclusions: Results showed that the use of zinc gluconate as a zinc supplement in infants with acute bronchiolitis could improve their clinical symptoms and signs and decrease the duration of hospitalization.
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References
Goodman D. Inflammatory disorder of the small. In:Behrman RE, Kliegman RM, Jenson HB, Editors. Nelson Textbook of Pediatrics. Philadelphia: WB Saunders; 2003.
Henderson FW, Clyde WA Jr, Collier AM. The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice. J Pediatr. 1979;95:183-90.
Smyth RL, Openshaw PJ. Bronchiolitis. Lancet. 2006;368:312-22.
Wright AL, Taussig LM, Ray CG, Harrison HR, Holberg CJ. The tucson children respiratory study. II. Lower respiratory tract illness in thefirst year of life. Am J Epidemiol. 2009;129:1232-46.
Kellner JD, Ohlsson A, Gadomski AM, Wang EE. Bronchodilators for bronchiolitis. Cochrane Database Syst Rev. 2000:Cd001266.
Scarfone RJ. Controversies in the treatment of bronchiolitis. Curr Opin Pediatr. 2005;17:62-6.
Sethi GR, Nagar G. Evidence based treatment of bronchiolitis. Indian J Pediatr. 2004;71:733-7.
Dawson-Caswell M, Muncie HL. Respiratory syncytial virus infection in children. Am Fam Physician. 2011;83(2) :141-6
Heydarian F, Behmanesh F, Daluee M, Kianifar H, Hematian M. The role of zinc sulfate in acute bronchiolitis in patients aged 2 to 23 months. Iranian J Pediatr. 2011;21(2):231-4.
Brooks WA, Yunus M, Santosham M. Zinc for severe pneumonia in very young children: doubleblind placebo-controlled trial. Lancet. 2004;363(9422):1683-8.
Mahalanabis D, Lahiri M, Paul D. Randomized, double-blind, placebo-controlled clinical trial of the efficacy of treatment with zinc or vitamin A in infants and young children with severe acute lower respiratory infection. Am J Clin Nutr. 2004;79(3):40-6.
Mahyar A, Ayazi P, Ahmadi NK, Nikoo ST, Hamzehloo S, Taremiha A, et al. Zinc sulphate for acute bronchiolitis: A double-blind placebo-controlled trial. Infez Med. 2016;4:331-6.
Yuan X, Qian SY, Li Z, Zhang ZZ. Effect of zinc supplementation on infants with severe pneumonia. World J Pediatr. 2016;12(2):166-9.
Fataki MR, Kisenge RR, Sudfeld CR, Aboud S, Okuma J, Mehta S, Spiegelman D, Fawzi WW. Effect of zinc supplementation on duration of hospitalization in Tanzanian children presenting with acute pneumonia. J Trop Pediatr. 2013;60(2):104-11.
Valentiner-Branth P, Shrestha PS, Chandyo RK, Mathisen M, Basnet S, Bhandari N, et al. A randomized controlled trial of the effect of zinc as adjuvant therapy in children 2-35 mo of age with severe or nonsevere pneumonia in Bhaktapur, Nepal. Am J Clin Nutr. 2010;91(6):1667-74.
Bose A, Coles CL, John H, Moses P, Raghupathy P, Kirubakaran C, et al. Efficacy of zinc in the treatment of severe pneumonia in hospitalized children<2 y old. Am J Clin Nutr. 2006;83(5):1089-96.
Nair BT, Bhunia R, Sharma KK. Role of zinc supplementation in acute respiratory tract infections in children aged 2 to 60 months. International J Contemporary Pediatrics. 2017;4(5):1758-62.
Valavi E, Hakimzadeh M, Shamsizadeh A, Aminzadeh M, Alghasi A. The efficacy of zinc supplementation on outcome of children with severe pneumonia. A randomized double-blind placebo-controlled clinical trial. Indian J Pediatrics. 2011;78(9):1079-84.
Basnet S, Shrestha PS, Sharma A, Mathisen M, Prasai R, Bhandari N, Adhikari RK, Sommerfelt H, Valentiner-Branth P, Strand TA, Zinc Severe Pneumonia Study Group. A randomized controlled trial of zinc as adjuvant therapy for severe pneumonia in young children. Pediatrics. 2012:peds-2011.
Sazawal, S, Black RE, Jalla S, Mazumdar S, Sinha A, Bhan MK. Zinc supplementation reduces the incidence of acute lower respiratory infections in infants and preschool children:a double-blind, controlled trial. Pediatrics 1998;102:1-5.
Bhutta ZA, Black RE, Borwn KH. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries:pooled analysis of randomized controlled trials. Zinc Investigators’ Collaborative Group. J Pediatr 1999;135:689-97.
Bhandari N, Bahl S, Taneja S. Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum. BMJ. 2002;324:1358.
Zorc JJ, Hall CB. Bronchiolitis:mRecent evidence on diagnosis and management. Pediatrics. 2010;125:342-9.