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Antioxidant vitamins E and C as adjunct therapy of severe acute lower-respiratory infection in infants and young children: a randomized controlled trial.

AbstractOBJECTIVE:
To evaluate the effect of antioxidant Vitamins E and C as adjunct therapy of severe acute lower respiratory infection (ALRI) in children.
DESIGN:
Randomized double-blind placebo-controlled clinical trial.
SETTING:
A large childrens' hospital serving the urban poor in Kolkata, India.
SUBJECTS:
Children aged 2-35 months admitted with severe ALRI.
INTERVENTION:
In total, 174 children were randomly assigned to receive alpha-tocopherol 200 mg and ascorbic acid 100 mg twice daily or placebo for 5 days. All children received standard treatment for severe ALRI. Outcome measures were: time taken to recover from a very ill status, fever, tachypnoea, and feeding difficulty; and improvement in oxidative stress and immune response indicated by thiobarbituric acid reacting substances (TBARS) and response to skin antigens, respectively.
RESULTS:
Recovery rate ratios (95% CI) using proportional hazards model were 0.89 (0.64-1.25), 1.01 (0.72-1.41), 0.86 (0.57-1.29), and 1.12 (0.77-1.64) for very ill status, feeding difficulty, fever, and tachypnoea, respectively. TBARS values were high and similar in the two groups at admission, discharge, and at 2 weeks follow-up. Serum alpha-tocopherol significantly increased in treated group at discharge. Immune response to skin antigens were very poor at admission and after 2 weeks, in both groups.
CONCLUSION:
Infants with severe ALRI failed to benefit from two antioxidant nutrients as adjunct therapy. Severe ALRI in infants may cause cell-mediated immune dysfunction. We need a better understanding of oxidative processes in growing infants to help us better design interventions with antioxidant therapy.
AuthorsD Mahalanabis, M Basak, D Paul, S Gupta, S Shaikh, M A Wahed, M A Khaled
JournalEuropean journal of clinical nutrition (Eur J Clin Nutr) Vol. 60 Issue 5 Pg. 673-80 (May 2006) ISSN: 0954-3007 [Print] England
PMID16391588 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antioxidants
  • Thiobarbituric Acid Reactive Substances
  • Vitamin E
  • Ascorbic Acid
Topics
  • Acute Disease
  • Antioxidants (metabolism, therapeutic use)
  • Ascorbic Acid (metabolism, therapeutic use)
  • Child, Preschool
  • Double-Blind Method
  • Female
  • Humans
  • Immunity, Cellular
  • India
  • Infant
  • Male
  • Oxidation-Reduction
  • Oxidative Stress (drug effects)
  • Proportional Hazards Models
  • Respiratory Tract Infections (drug therapy)
  • Severity of Illness Index
  • Thiobarbituric Acid Reactive Substances (analysis)
  • Treatment Outcome
  • Vitamin E (metabolism, therapeutic use)

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