Can Vitamin D Reduce Repeat Pneumonia Episodes in Children? -EMJ

Can High-Dose Vitamin D Supplements Reduce Repeat Pneumonia Episodes in Children?

A SYSTEMATIC review regarding the benefits of using high-dose vitamin D supplements in paediatric populations was presented at the 8th Respiratory Syncytial Virus Foundation (ReSViNET) Conference, held in Mumbai, India, between the 13th-16th February 2024. 

Researchers investigated the effectiveness of administering high-dose vitamin D supplementation to children, in order to reduce the incidence rate of contracting repeated episodes of pneumonia. The research team, led by the Universidad de Antioquia, Medellin, Colombia, and the Nuffield Department of Population Health, University of Oxford, UK, explored 125(OH)2D3, which is a pivotal component in immune cell response to pathogens. Currently, there is no agreed consensus within clinical practice guidelines which recommends vitamin D supplementation to lessen the recurrence of pneumonia. 

The study used searches from computerised databases (MEDLINE, Embase, the Cochrane Central Register of Controlled Titles [CENTRAL], and LILACS), alongside references cited in published literature. Potentially applicable studies conducted between January 2020–January 2023 were considered. Researchers selected those studies which have evaluated the use of vitamin D as a supplementary treatment alongside antibiotics, in patients <18 years of age. All patients were hospitalised with a pneumonia diagnosis, and had recurrent episodes of pneumonia following hospitalisation. In total, 115 citations were found, and 12 studies were examined in full. 

Presenting author, Jefferson Antonio Buendia, Universidad de Antioquia, stressed that the research team discovered no publication bias. In conclusion, the analysis ascertained that administering vitamin D alongside antibiotic treatment does not reduce the risk of repeated episodes of pneumonia (risk ratio: 0.70; 95% confidence interval: 0.47–1.04). There was also no significant observed effect when a single dose was used, compared to no single dose being administered. 

Researchers found that the use of vitamin D does not reduce rates of mortality in paediatric patients with pneumonia (risk ratio: 0.78; 95% confidence interval: 0.54–1.13). The authors hope that their analysis will inform clinical practice guidelines in future, by providing evidence to decision-makers. 

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