Zinc reduces treatment failure in children with major infections

by Bruce Sylvester – taken from The Lancet –

Young children with suspected serious bacterial infection treated with zinc and standard antibiotics have achieved a significantly reduced rat treatment failure, according to a study published online on May 30 and appearing in an upcoming print issue of The Lancet.

This is the first study to evaluate the efficacy of zinc supplementation in suspected serious bacterial infections such as pneumonia, sepsis, and meningitis.

“Zinc is an accessible, low-cost intervention that could add to the effect of antibiotic treatment and lead to substantial reductions in infant mortality, particularly in developing countries where millions of children die from serious infections every year, and where second-line antibiotics and appropriate intensive care might not be available,” explained Shinjini Bhatnagar, MD, Translational Health Science and Technology Institute, and All India Institute of Medical Sciences, New Delhi, India.

Researchers randomized very children, aged 7 to 120 days, who were being treated with antibiotics for serious infections in 3 hospitals in New Delhi to also receive either daily oral  zinc 10 mg (n = 352) or placebo (n = 348) each day.

They reported that zinc-treated subjects  were 40% less likely to experience treatment failure (measured as the need for secondary antibiotic treatment within 7 days, need for treatment in intensive care, or death within 21 days) than subjects receiving placebo.

There were 34 treatment failures in 332 children who received zinc, and 55 in 323 children given placebo, a relative risk reduction of 40%. Although not statistically significant, there was also a relative reduction (of 43%) in risk of death in the group assigned to zinc.

“We would only need to give 15 children with probable serious bacterial infection zinc to prevent 1 treatment failure,” said Dr. Bhatnagar.

“Zinc syrup or dispersible tablets are already available in the public and private healthcare systems for treatment of acute diarrhoea in many countries of low and middle income and the incremental costs to make this intervention available for young infants with probable serious bacterial infection would be small,” the authors concluded.

In an accompanying comment, Christa Fischer Walker and Robert Black, John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, said, “This finding is important because case fatality is high in infants presenting with symptoms of probable serious bacterial infection. The exact mechanism for the effect of supplemental zinc is unknown and needs further investigation, but the clinical benefits in diarrhoea and pneumonia in children younger than 5 years, and now in probable serious infections in young infants, suggest that therapeutic use of zinc could have wide application. Additionally, zinc could be beneficial…for other serious bacterial infections, such as those causing typhoid fever or meningitis.”