Vitamin A supplementation in acute diarrhea

Background: Vitamin A supplementation reduces the severity of subsequent diarrheal episodes. This study was conducted to examine the effect of single oral high-dose vitamin A supplementation on the duration of acute diarrhea in 6- to 12-month-old infants who are not malnourished. Method: In this double-blind, randomized, placebo-controlled study, infants who were admitted to Hacettepe University Ihsan Dogramaci Children's Hospital Diarrheal Diseases Training and Treatment Unit with acute diarrhea were randomly assigned either to a group receiving a single oral dose of 100,000 IU vitamin A or placebo. There were 60 infants in each group. All infants were followed up until the diarrheal episode ended. Serum vitamin A levels were determined both at admission and 2 weeks later. Results: No effect of vitamin A supplementation could be demonstrated on either the total duration of diarrhea (7.4 ± 3.2 days in the treatment group vs. 7.8 ± 3.1 days in the placebo group) or on its duration after intervention (3.8 ± 2.3 days in the treatment group vs. 3.9 ± 1.9 days in the placebo group; P > 0.05 for both comparisons). Serum vitamin A levels were not significantly different at admission (23.5 ± 9.7 μg/dL in the treatment group vs. 24.1 ± 9.7 μg/dL in the placebo group; P > 0.05) nor at the end of a follow-up period of 2 weeks (treatment: 33.3 ± 13.7 μg/dL, placebo: 35.2 ± 11.2 μg/dL; P > 0.05). However, the increase in serum vitamin A levels at the end of the 2-week follow-up interval for infants in both the treatment and placebo groups were found to be significant compared with levels at admission (P < 0.01). The mean weight gain in both groups were similar by the end of the first month (6.9 ± 5.0% in the treatment group vs. 6.3 ± 4.2% in the placebo group; P > 0.05). Conclusion: No effect of oral vitamin A supplementation on serum vitamin A levels, duration of diarrhea, or weight gain during an acute diarrheal episode could be demonstrated in our study group of infants between 6 and 12 months of age who had no malnutrition. (C) 2000 Lippincott Williams and Wilkins, Inc.