CLINICAL-TRIAL OF VITAMIN-A AS ADJUVANT TREATMENT FOR LOWER RESPIRATORY-TRACT INFECTIONS

Objective: To test the efficacy of a high dose of vitamin A as adjuvan t treatment for radiographically confirmed cases of acute lower respir atory tract infection (ALRI). Design: Randomized, double-masked, place bo-controlled clinical trial. Setting: Two large urban hospitals in Gu atemala City. Patients: Sequential sample of 263 children aged 3 to 48 months, identified in the emergency departments and admitted to the h ospital. Interventions: Vitamin A (100,000 IU for children less than I year of age, and 200,000 IU for older children) or placebo in additio n to standard treatment for ALRI which included antibiotics, oxygen, b ronchodilators, and intravenously administered solutions. Measurements and main results. The children were assessed every 8 hours, There wer e neither statistically nor clinically significant differences by trea tment group in the rate of normalization in respiratory rate, oxygen s aturation, temperature, or clinical score. Duration of hospitalization was not different by treatment group, Adverse outcomes (mechanical ve ntilation, prolonged hospitalization, readmission or transfer, and dea th) were equally distributed between the two groups. Conclusions: Trea tment with high doses of vitamin A over and above standard care for in fants and children with non-measles-related ALRI is not efficacious fo r the current episode, Additional trials among populations in which vi tamin A deficiency is more prevalent and severe should be considered.