Zinc Gluconate Lozenges for Treating the Common Cold in Children

Abstract

Context.-The common cold is one of the most frequently occurring illnesses and is responsible for substantial morbidity and economic loss. Biochemical evidence suggests that zinc may be an effective treatment, and zinc gluconate glycine (ZGG) lozenges have been shown to reduce the duration of cold symptoms in adults. Objective.-To determine the efficacy of ZGG treatment of colds in children and adolescents. Design.-A randomized, double-masked, placebo-controlled study. Setting.-Two suburban school districts in Cleveland, Ohio. Patients.-A total of 249 students in grades 1 through 12 were enrolled within the first 24 hours of experiencing at least 2 of 9 symptoms of the common cold. Intervention.-Zinc lozenges, 10 mg, orally dissolved, 5 times a day (in grades 1-6) or 6 times a day (in grades 7-12). Main Outcome Measures.-Time to resolution of cold symptoms based on subjective daily symptom scores for cough, headache, hoarseness, muscle ache, nasal congestion, nasal drainage, scratchy throat, sore throat, and sneezing. Results.-Time to resolution of all cold symptoms did not differ significantly between students receiving zinc (n = 124) and those receiving placebo (n = 125) (median, 9 days; 95% confidence interval [CI], 8-9 days; median, 9 days, 95% CI, 7-10 days, respectively; P = .71). There were no significant differences in the time to resolution of any of the 9 symptoms studied. Compared with controls, more students in the zinc group reported adverse effects (88.6% vs 79.8%; P = .06); bad taste (60.2% vs 37.9%; P = .001); nausea (29.3% vs 16.1%; P = .01); mouth, tongue, or throat discomfort (36.6% vs 24.2%; P = .03); and diarrhea (10.6% vs 4.0%; P = .05). Conclusions.-In this community-based, randomized controlled trial, ZGG lozenges were not effective in treating cold symptoms in children and adolescents. Further studies with virologic testing are needed to clarify what role, if any, zinc may play in treating cold symptoms.

Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials

“…To address concerns over potentially inadequate blinding to the taste of the placebo, we conducted a post hoc sensitivity analysis in which we excluded trials that reported significant differences in bad taste between zinc and placebo arms 33,34 or did not report a bad taste outcome. 30,35 After excluding these trials, the duration of cold symptoms still favoured zinc, with a …”

“…Heterogeneity: I² = 82% Children Kurugöl et al 31 Kurugöl et al 32 Macknin et al 33 Subtotal Heterogeneity: I² = 84%…”

“…Kurugöl et al 31 Kurugöl et al 32 Macknin et al 33 Mossad et al 34 Petrus et al 35 Subtotal Heterogeneity: I² = 89% Overall Heterogeneity: I² = 95% Test for subgroup differences: χ² = 7.99, df = 1 (p = 0.005), I² = 87.5% …”

“…11 First, we used a different approach to estimating means and standard deviations in trials that reported only medians. 32,33 In the Cochrane review, the authors calculated the means and standard deviations by assuming that the 95% CIs presented around the medians also reflected 95% CIs around the means. 11 However, this approach resulted in one trial estimate showing a significant difference between the zinc and placebo groups, 32 a finding inconsistent with the authors' conclusion of no difference.…”

Viral Respiratory Tract Infections in Cystic Fibrosis

“…Postulated mechanisms in the common cold include interfering with rhinovirus protein cleavage or capsid binding to ICAM-1 in nasal epithelium (Novick, Godfrey et al 1996). Zinc lozenges appeared to have positive effects on adults but negative effects on children in terms of duration and severity of common cold symptoms (Macknin, Piedmonte et al 1998;Marshall 2000). Higher doses were found to have a greater impact in reduction of symptom duration and reduced symptom severity (Godfrey, Conant Sloane et al 1992;Mossad, Macknin et al 1996).…”