Zinc as Adjunct Therapy in Neonatal Sepsis

Abstract

Introduction:Altered zinc homeostasis is an important feature of pediatric sepsis, thus raising the possibility of zinc supplementation as a therapeutic strategy in neonatal sepsis, a major source of morbidity and mortality with few therapeutic options beyond antibiotics. Its objective was to find the role of zinc as adjunct therapy in neonatal sepsis.
 Materials and Methods: This prospective, randomized double blind placebo controlled trial was conducted in the Department of Paediatrics, Sylhet M A G Osmani Medical College, Sylhet, Bangladesh during January 2013 to December 2014. A total 288 neonates with neonatal sepsis were enrolled. Group allocation to either zinc or placebo group was done by lottery method. Each packet contained 5 mg dispersible zinc sulphate or placebo. One packet dissolved in 2.5 ml expressed breast milk was given orally or through feeding tube.
 Results: The age of the patients in zinc group and placebo group was 14.40 ± 6.49 days and 15.09 ± 7.18 days respectively. There were 49 (75.6%) male neonates and 16 (24.6%) female neonates in zinc group; while 50 (78.1%) neonates were male and 14 (21.9%) were female in placebo group. Clinical recovery was 61 (93.8%) and failure in 4 (6.2%) patients in zinc group; while clinical recovery was 59 (92.2%) and failure in 5 (7.8%) patients in placebo group. The mean clinical recovery time in zinc group was 104.20 ± 16.61 hours and that of control groups was 111.46 ± 19.43 hours.
 Conclusion: Oral zinc as adjunct therapy shortens the clinical recovery time.
 Medicine Today 2020 Vol.32(2): 112-116

Zinc Supplementation and the Prevention and Treatment of Sepsis in Young Infants: A Systematic Review and Meta-Analysis

“…Five studies were conducted in India, 2 in Egypt, and one each in Nepal, Pakistan, Bangladesh, and Italy. The study settings included pediatric inpatient wards [25, 27, 29, 30], neonatal ICUs [18, 19, 24, 26, 28, 32], and the community [31]. The characteristics of included studies are as shown in Table 1.…”

“…The minimum sample size reported was 72 children [30] and the maximum population size was 700 children [25]. Eight [18, 19, 24-27, 29, 32] of the included studies reported the therapeutic effect of zinc supplementation, whereas only 3 studies [28, 30, 31] evaluated the preventive efficacy of the zinc supplement. We report below the preventive and therapeutic effects of zinc supplementation in neonates and young infants, respectively.…”

“…A total of 8 trials [18, 19, 24-27, 29, 32] reported the therapeutic effect of zinc supplementation on proven sepsis in infants up to 4 months of age, all in LMICs. Six studies were conducted in infants admitted to intensive care with sepsis whereas 2 studies recruited infants from inpatient facilities.…”

“…After removal of duplicates and the initial title and abstract screening, 10 studies underwent full-text screening. After full-text screening and inclusion of one article from other resources, 11 RCTs [18,19,[24][25][26][27][28][29][30][31][32] were finally included in the review.…”

“…RCTs [18,19,[24][25][26][27][28][29][30][31][32] were finally included in the review. Two studies [18,19] were excluded from full text review as they were substudies of an already included trial [24].…”