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 ≤5 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 (±SD) 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 [5–8]. 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
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