Vitamin D status is associated with treatment failure and duration of illness in Nepalese children with severe pneumonia

Pediatr Res. 2017 Dec;82(6):986-993. doi: 10.1038/pr.2017.71. Epub 2017 Aug 16.

Abstract

BackgroundThere is no consensus on optimal Vitamin D status. The objective of this study was to estimate the extent to which vitamin D status predicts illness duration and treatment failure in children with severe pneumonia by using different cutoffs for vitamin D concentration.MethodsWe measured the plasma concentration of 25(OH)D in 568 children hospitalized with World Health Organization-defined severe pneumonia. The associations between vitamin D status, using the most frequently used cutoffs for vitamin D insufficiency (25(OH)D<50 and <75 nmol/l), and risk for treatment failure and time until recovery were analyzed in multiple logistic regression and Cox proportional hazards models, respectively.ResultsOf the 568 children, 322 (56.7%) had plasma 25(OH)D levels ≥75 nmol/l, 179 (31.5%) had levels of 50-74.9 nmol/l, and 67 (%) had levels <50 nmol/l. Plasma 25(OH)D <50 nmol/l was associated with increased risk for treatment failure and longer time until recovery.ConclusionOur findings indicate that low vitamin D status (25(OH)D<50 nmol/l) is an independent risk factor for treatment failure and delayed recovery from severe lower respiratory infections in children.

Trial registration: ClinicalTrials.gov NCT00252304.

MeSH terms

  • Amoxicillin / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Nepal
  • Pneumonia, Bacterial / blood
  • Pneumonia, Bacterial / complications
  • Pneumonia, Bacterial / drug therapy*
  • Proportional Hazards Models
  • Severity of Illness Index
  • Treatment Outcome
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications

Substances

  • Anti-Bacterial Agents
  • Vitamin D
  • Amoxicillin
  • 25-hydroxyvitamin D

Associated data

  • ClinicalTrials.gov/NCT00252304