Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 30024634 · doi:10.1002/14651858.CD011597.pub2
What was done
This Cochrane systematic review searched CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and WHO ICTRP through July 2017 for randomized controlled trials evaluating vitamin D supplementation as an adjunct to antibiotics in children aged 1 month to 5 years hospitalized with acute community-acquired pneumonia. Reviewers independently extracted data and assessed certainty using GRADE.
What was found
Seven RCTs with 1,529 children from low-income countries were included. Vitamin D regimens varied (single 100,000 IU dose in 4 trials; 1,000–2,000 IU/day for 5 days in 2 trials; 50,000 IU/day for 2 days in 1 trial). Adjunctive vitamin D showed inconclusive effects across all reported outcomes: - Time to resolution of acute illness: MD -0.95 hours (95% CI -6.14 to 4.24; 3 studies, 935 children; low-quality evidence) - Duration of hospitalization: MD 0.49 hours (95% CI -8.41 to 9.40; 4 studies, 835 children; very low-quality evidence) - Time to resolution of fever: MD 1.66 hours (95% CI -2.44 to 5.76; 4 studies, 584 children; very low-quality evidence) - Mortality: RR 0.97 (95% CI 0.06 to 15.28; 1 study, 193 children; very low-quality evidence) No major adverse events were reported.
Why it matters
Adjunctive vitamin D does not show clear clinical benefit for reducing illness duration, hospital stays, or mortality in young children hospitalized with acute pneumonia.
Limits
Certainty of evidence was rated low to very low across all outcomes due to serious study limitations, imprecision from small numbers of events/wide confidence intervals, indirectness, and inconsistency. Only one trial confirmed diagnosis using microbiological and radiological criteria. Dosing regimens varied substantially, and all studies were conducted in low-income countries.
Cited by
- partial Vitamin D shortens the duration of infections and helps prevent cytokine storms, sepsis, and autoimmune diseases by modulating immune system overreactions.