%0 Journal Article
%T Vitamin D Supplementation for the Treatment of Acute Childhood Pneumonia: A Systematic Review
%A Rashmi Ranjan Das
%A Meenu Singh
%A Inusha Panigrahi
%A Sushree Samiksha Naik
%J ISRN Pediatrics
%D 2013
%R 10.1155/2013/459160
%X Background. Studies have found an increased incidence of vitamin D deficiency in children with pneumonia; however, there is no conclusive data regarding the direct effect of vitamin D supplementation in acute pneumonia. Methods. A comprehensive search was performed of the major electronic databases till September 2013. Randomized controlled trials (RCTs) comparing treatment with vitamin D3 versus placebo in children ¡Ü5 years old with pneumonia were included. Results. Out of 32 full text articles, 2 RCTs including 653 children were eligible for inclusion. One trial used a single 100,000 unit of oral vitamin D3 at the onset of pneumonia. There was no significant difference in the mean (¡ÀSD) number of days to recovery between the vitamin D3 and placebo arms ( ). Another trial used oral vitamin D3 (1000£¿IU for <1 year and 2000£¿IU for >1 year) for 5 days in children with severe pneumonia. Median duration of resolution of severe pneumonia was similar in the two groups (intervention, 72 hours; placebo, 64 hours). Duration of hospitalization and time to resolution of tachypnea, chest retractions, and inability to feed were also comparable between the two groups. Conclusions. Oral vitamin D supplementation does not help children under-five with acute pneumonia. 1. Introduction Worldwide, acute lower respiratory tract infection (ALRTI) is a leading cause of mortality in children less than 5 years old [1, 2]. More than 90% are in developing countries. The management of ALRTI includes intravenous antibiotics, oxygen, or assisted ventilation (in severe cases). Besides these, nutritional supplementations such as zinc and vitamin A supplementation have been tried, though the results have been unfavorable [3, 4]. Researchers have found that deficiency in vitamin D may predispose people to infection, and thus vitamin D has been labeled as antibiotic vitamin [5]. The immune enhancing actions of vitamin D include induction of monocyte differentiation, inhibition of lymphocyte proliferation, stimulation of phagocytosis dependent and antibody-dependent macrophages, and modulation of T and B lymphocytes that produce cytokines and antibodies [5¨C8]. Vitamin D deficiency if severe leads to chest wall deformity, hypotonia, poor chest wall compliance, atelectasis, and fibrosis [9]. All these factors contribute to a higher incidence of pneumonia in children with severe vitamin D deficiency. A recent meta-analysis of randomized controlled trials (RCTs) showed that prophylactic vitamin D supplementation in the pediatric age group reduced the rate of respiratory tract infections
%U http://www.hindawi.com/journals/isrn.pediatrics/2013/459160/