A Cochrane review [Abstract] 1 included 6 studies with a total of 1 740 subjects. There was no significant reduction in the mortality associated with pneumonia in children treated with vitamin A compared to those who were not (pooled OR 1.29, 95% CI 0.63 to 2.66; 3 studies, n=1 446). In addition, there was a lack of a statistically significant effect on duration of stay in hospital (MD 0.08, 95% CI -0.43 to 0.59; 2 studies, n=779). Vitamin A was associated with a 39% reduction in antibiotic firstline failure (OR 0.65, 95% CI 0.42 to 1.01; 1 study, n=472). Children receiving vitamin A were no more likely to experience vomiting (OR 0.77, 95% CI 0.45 to 1.33; 2 studies, n=430), diarrhoea (OR 0.57, 95% CI 0.31 to 1.05; 1 study, n=405), bulging of the fontanelles (OR 8.25, 95% CI 0.44 to 155.37; 1 study, n=186) or irritability (OR 0.93, 95% CI 0.56 to 1.57; 1 study, n=306) than those not receiving vitamin A. There was no statistical significance between vitamin A and placebo groups (MD 0.90, 95% CI -1.10 to 2.90; 1 study, n=39) in chest x-ray results. Disease severity after supplementary high-dose vitamin A was significantly worse in children who received vitamin A compared with placebo. Low-dose vitamin A was associated with a significant reduction in the recurrent rate of bronchopneumonia (OR 0.12, 95% CI 0.03 to 0.46; 1 study, n=80). Moderate vitamin A significantly reduced the time to remission of signs (MD -61.40, 95% CI -119.10 to -3.7; 1 study, n=52) in children with normal serum retinol (> 200 ug/L).
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