VITAMIN-A THERAPY FOR CHILDREN WITH RESPIRATORY SYNCYTIAL VIRUS-INFECTION - A MULTICENTER TRIAL IN THE UNITED-STATES

Background, High dose vitamin A therapy is effective in reducing morbi dity and mortality associated with measles infection. Children with ac ute respiratory syncytial virus (RSV) infection have low serum vitamin A concentrations. Methods. We performed a multicenter, randomized, pl acebo-controlled trial of high dose vitamin A therapy among 239 childr en 1 month to 6 years of age to determine whether high dose vitamin A therapy would reduce morbidity associated with RSV infection. Results. There were no differences between the vitamin A and placebo recipient s for most clinical outcomes; however, vitamin A recipients had longer hospital stays than placebo recipients (5.0 days vs. 4.4 days, P = 0. 01) after enrollment. This effect was significant for children who wer e older than 1 year (who also had received the highest doses of vitami n A), particularly among those at low risk for complications of RSV in fection and those enrolled during the second study season. Serum retin ol levels at enrollment were inversely correlated with severity of ill ness. Conclusion. We found no evidence of a beneficial effect of vitam in A for the treatment of RSV infection in children in the United Stat es. There may be groups of children for which vitamin A has an adverse effect, resulting in longer hospital stays.