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zoom RSS 亜鉛の補充で乳児重症感染の死亡リスク軽減

<<   作成日時 : 2012/06/06 20:07   >>

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 インドでの新たな研究によると、抗生物質治療中の新生児の重症感染症で亜鉛を追加することで死亡率が低下したという。
 700人以上の乳幼児の肺炎・髄膜炎・敗血症に対して亜鉛を投与した群と投与しなかった群で比較すると、投与群で死亡率が40%低かった。


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Zinc: Supplements for Babies Being Treated With Antibiotics Appear to Save Lives
http://www.nytimes.com/2012/06/05/health/giving-zinc-to-seriously-ill-infants-appears-to-save-lives.html

By DONALD G. McNEIL Jr.
Published: June 4, 2012

画像Giving zinc to newborns being treated with antibiotics for serious infections appears to save lives, according to a new study done in India.

The study, published online in The Lancet last week, compared more than 700 infants under 4 months old who had pneumonia, meningitis or sepsis; half got zinc and half got placebo. The zinc group had 40 percent less “treatment failure,” by which the authors meant anything from death to a decision to switch antibiotics because standard ones were not working. Seventeen children in the placebo group died; only 10 who got zinc did.

The study is “a major finding” but should be replicated before global policy is changed, said Dr. Robert E. Black, an expert in zinc supplementation at the Johns Hopkins Bloomberg School of Public Health who was not involved in the study.

Why zinc seems to help cure infections, diarrhea and pneumonia in zinc-deficient children is unknown, Dr. Black said. Zinc may work very differently when given briefly to dangerously ill children rather than as a supplement given regularly to healthy ones.

Vegetarian diets, like those of Hindus, are often zinc-deficient, Dr. Black said, but so are those of many malnourished children. Breast milk ? even from zinc-deficient mothers ? contains zinc, though it depletes the mother’s reserves. But when rice or wheat gruel is added to a baby’s diet, he said, phytates in the grain may block zinc absorption.


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he Lancet, Volume 379, Issue 9831, Pages 2072 - 2078, 2 June 2012
doi:10.1016/S0140-6736(12)60477-2Cite or Link Using DOI
Published Online: 31 May 2012

Zinc as adjunct treatment in infants aged between 7 and 120 days with probable serious bacterial infection: a randomised, double-blind, placebo-controlled trial

Prof Shinjini Bhatnagar PhD a c , Nitya Wadhwa MD a c, Prof Satinder Aneja MD d, Rakesh Lodha MD b, Prof Sushil Kumar Kabra MD b, Uma Chandra Mouli Natchu MD c e, Prof Halvor Sommerfelt PhD f g, Prof Ashok Kumar Dutta MD d, Prof Jagdish Chandra MD d, Prof Bimbadhar Rath MD d, Mamta Sharma MD h, Vinod Kumar Sharma MD h, Mohini Kumari MD h, Tor A Strand PhD f g i
Summary

Background
Serious bacterial infections are a major cause of death in early infancy in developing countries. Inexpensive and accessible interventions that can add to the effect of standard antibiotic treatment could reduce infant mortality. We measured the effect of zinc as an adjunct to antibiotics in infants with probable serious bacterial infection.
Methods
In this randomised, double-blind, placebo-controlled trial, we enrolled infants aged 7?120 days with probable serious bacterial infection at three hospitals in New Delhi, India, between July 6, 2005, and Dec 3, 2008. With computer-generated sequences, we randomly assigned infants in permuted blocks of six, stratified by whether patients were underweight or had diarrhoea at enrolment, to receive either 10 mg of zinc or placebo orally every day in addition to standard antibiotic treatment. The primary outcome was treatment failure, which was defined as a need to change antibiotics within 7 days of randomisation, or a need for intensive care, or death at any time within 21 days. Participants and investigators were masked to treatment allocation. All analyses were done by intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT00347386.
Findings
352 infants were randomly assigned to receive zinc and 348 to placebo. 332 given zinc and 323 given placebo could be assessed for treatment failure. Significantly fewer treatment failures occurred in the zinc group (34 [10%]) than in the placebo group (55 [17%]; relative risk reduction 40%, 95% CI 10?60, p=0・0113; absolute risk reduction 6・8%, 1・5?12・0, p=0・0111). Treatment of 15 (95% CI eight to 67) infants with zinc would prevent one treatment failure. Ten infants receiving zinc died compared with 17 given placebo (relative risk 0・57, 0・27?1・23, p=0・15).
Interpretation
Zinc could be given as adjunct treatment to reduce the risk of treatment failure in infants aged 7?120 days with probable serious bacterial infection.
Funding
Department of Biotechnology, Government of India; the European Commission; the Meltzer Foundation; and the Research Council of Norway.

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亜鉛の補充で乳児重症感染の死亡リスク軽減 医師の一分/BIGLOBEウェブリブログ
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