Report an error   

Submitted: 09 February 2015 Modified: 22 August 2019
HERDIN Record #: NCR-UERMMMC-15020906031038

Effect of zinc supplementation as an adjunct in the treatment of pneumonia in children: a meta-analysis.

See More

Introduction This meta-analysis was done to evaluate the efficacy of zinc supplementation as adjunct to antibiotics in decreasing the duration of resolution of tachypnea, time to recovery, and length of hospital stay of pneumonia in children 2 to 59 months.

Methods This was a meta-analysis of randomized, blinded, placebo-controlled intervention trials. The studies for inclusion were identified from several international and local search engine and journal hand search. Included studies were appraised for validity. Statistical analysis of the data was done using Review Manager Version 5.2. Summary mean difference and 95% confidence interval for each outcome variable were estimated using a random-effects model in the presence of significance heterogeneity. Tests for heterogeneity were computed using tau-square and chi-square.

Results There was no difference in children who received elemental zinc as adjunct to antibiotics in terms of decreasing the duration of resolution of tachypnea (P = 0.48, 955 CI - 13.76, 6.41), time to recovery (P = 0.11, 95% CI - 10.18, 1.00) and length of hospital stay (P = 0.05, 95% CI - 11.54, 0.04).

Conclusion This study showed that there was no significant evidence for the efficacy of zinc supplementation as an adjunct in the treatment of pneumonia in children despite including newer studies for analysis.

Publication Type
Publication Sub Type
Journal Article, Original
The Health Sciences Journal
Publication Date
January-June 2014
LocationLocation CodeAvailable FormatAvailability
UERMMMC Fulltext Print Format
1. Rudan, I , Boschi-Pinto, C , Biloglav, Z . "Epidemiology and etiology of childhood pneumonia " Bull WHO 86, 312-6, 2008
2. Department of Health, . (2005, November 30). Health statistics -- Leading causes of morbidity, infant mortality ten (10) leading causes, leading causes of child mortality.. . Retrieved from:
3. Black, R . "Zinc deficiency, infectious disease and mortality in the developing world." J Nutri 13, 1485S-9S, 2003
4. Sazawal , S , Black, R E, Jalla, S , Mazumdar, D , Sinha, A , Bhan, M K. "Zinc supplementation reduces the incidence of acute lower respiratory infections in infants and preschool children: a double-blind, controlled trial." Pediatrics 102, 1-5, 1998
5. Ninh, N X, Thissesn, J P, Collette, L , Gerard, G , Khoi, H H, Ketelslegers, J M. "Zinc supplementation increases growth and circulating insulin-like growth factor I (IGF-I) in growth retarded Vietnamese children." Am J Clin Nutr 63, 514-9, 1996
6. Bhutta, Z A, Black, R E, Brown, K H. "Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries:pooled analysis of randomized controlled trials. Zinc Investigator" J Pediatr 135, 689-97, 1999
7. Bhandari, N , Bahl, S , Brown, K H. "Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum." BMJ 324, 1358, 2002
8. Roy, S K, Tomkins, A M, Akramuzzaman, S M. "Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhea." Arch Dis Child 77, 196-200, 1997
9. Bhutta, Z A, Bird, S M, Black, R E. "Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials." Am J Clin Nutr 72, 1516-22, 2000
10. Baqui, A H, Black, R E, Arifeen, S . "Effects of zinc supplementation started during diarrhoea on morbidity and mortality in Bangladeshi children: community randomized trial." BMJ 325, 1059, 2002
11. Philippine Pediatric, . Clinical practice guidelines in the evaluation and management of pediatric community acquired pneumonia.. 2004.
12. Haider, B A, Lassi, Z S, Ahmed, A , Bhutta, Z A. "Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age." Cochrane Database of Systematic Reviews , 2011
13. Abat, KAC , Mantaring, JBV . "Efficacy of zinc as an adjunct in the treatment of pneumonia in children " Philipp J Pediatr 57(1): 32-6, 2008
14. Bansal, A , Parmar, V R, Basu, S . "zinc supplementation in severe acute lower respiratory tract infection in children: a triple-blind randomized placebo controlled trial. " Indian J Pediatr 78(1): 33-7, 2011
15. Bose, A , Coles, C l, Gunavathi, J H. "Efficacy of zinc in the treatment of severe pneumonia in hospitalised children " Am J Clin Nutr 83(5): 1089-96, 2006
16. Brooks, W A, Yunus, M , Satosham, M . "Zinc for severe pneumonia in very young children: double-blind, placebo-controlled trial." The Lancet 363(9422): 1683-8, 2004
17. Mahalanabis, D , Lahiri, M , Paul, D . "Randomized, double-blind, placebo-controlled clinical trial of the efficacy of treatment with zinc or vitamin A in infants and young children with severe acute lower respiratory infection." Am J Clin Nutr 79(3): 430-6, 2004
18. Valavi, E , Hakimzadeh, M , Shamsizadeh, A , Aminzadeh, M , Alghasi, A . "The efficacy of zinc supplementation on outcome of children with severe pneumonia. A randomized double-blind placebo-controlled trial." Indian J Pediatr 78(9): 1079-84, 2011
19. Basnet, S , Prakash, S , Sharma, A . "A randomized controlled trial of zinc as adjuvant therapy for severe pneumonia in young children." Pediatrics 129(701-8): 2012
20. Valentiner-Branth, P , Shrestha, P S, Chandyo, R K. "A randomised controlled trial of the effect of zinc as adjuvant therapy in children 2-35 months of age with severe or non-severe pneumonia in Bhaktapur, Nepal." Am J Clin Nutr 96(1): 1667-74, 2010
21. King, J C, Shames, D M, Woodhouse , L R. "Zinc homeostasis in humans" J Nutr 130, 1360S-6S, 2000
22. Mizgerd, J P. "Acute lower respiratory tract infection" New England Journal of Medicine 358, 716-27, 2008
23. Prasad, A S. "Zinc: role in immunity, oxidative stress and chronic inflammation." Current Pin Clin Nutr Metab Care 12, 646-52, 2009
24. Lazzerini, M , Ronfani, L . "Oral zinc fro treating diarrhea in children." Cochrane Database of Systematic Reviews 13(6): June 2012
25. Aggarwal, R , Sentz, J , Miller, M A. "Role of zinc administration in prevention of childhood diarrhea and respiratory illnesses: a meta-analysis." Pediatrics 119, 1120-30, 2007