Vitamin C for preventing and treating pneumonia

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http://hdl.handle.net/10138/225862

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Hemilä , H & Louhiala , P 2013 , ' Vitamin C for preventing and treating pneumonia ' , Cochrane database of systematic reviews , no. 8 , CD005532 . https://doi.org/10.1002/14651858.CD005532.pub3

Title: Vitamin C for preventing and treating pneumonia
Author: Hemilä, Harri; Louhiala, Pekka
Contributor: University of Helsinki, Public Health
University of Helsinki, Hjelt Institute
Date: 2013
Number of pages: 45
Belongs to series: Cochrane database of systematic reviews
ISSN: 1469-493X
URI: http://hdl.handle.net/10138/225862
Abstract: BACKGROUND: Pneumonia is one of the most common serious infections, causing two million deaths annually among young children in low-income countries. In high-income countries pneumonia is most significantly a problem of the elderly. OBJECTIVES: To assess the prophylactic and therapeutic effects of vitamin C on pneumonia. SEARCH METHODS: We searched CENTRAL 2013, Issue 3, MEDLINE (1950 to March week 4, 2013), EMBASE (1974 to April 2013) and Web of Science (1955 to April 2013). SELECTION CRITERIA: To assess the therapeutic effects of vitamin C, we selected placebo-controlled trials. To assess prophylactic effects, we selected controlled trials with or without a placebo. DATA COLLECTION AND ANALYSIS: Two review authors independently read the trial reports and extracted data. MAIN RESULTS: We identified three prophylactic trials which recorded 37 cases of community-acquired pneumonia in 2335 people. Only one was satisfactorily randomised, double-blind and placebo-controlled. Two trials examined military recruits and the third studied boys from "lower wage-earning classes" attending a boarding school in the UK during World War II. Each of these three trials found a statistically significant (80% or greater) reduction in pneumonia incidence in the vitamin C group. We identified two therapeutic trials involving 197 community-acquired pneumonia patients. Only one was satisfactorily randomised, double-blind and placebo-controlled. That trial studied elderly patients in the UK and found lower mortality and reduced severity in the vitamin C group; however, the benefit was restricted to the most ill patients. The other therapeutic trial studied adults with a wide age range in the former Soviet Union and found a dose-dependent reduction in the duration of pneumonia with two vitamin C doses. We identified one prophylactic trial recording 13 cases of hospital-acquired pneumonia in 37 severely burned patients; one-day administration of vitamin C had no effect on pneumonia incidence. The identified studies are clinically heterogeneous which limits their comparability. The included studies did not find adverse effects of vitamin C. AUTHORS' CONCLUSIONS: The prophylactic use of vitamin C to prevent pneumonia should be further investigated in populations who have a high incidence of pneumonia, especially if dietary vitamin C intake is low. Similarly, the therapeutic effects of vitamin C should be studied, especially in patients with low plasma vitamin C levels. The current evidence is too weak to advocate prophylactic use of vitamin C to prevent pneumonia in the general population. Nevertheless, therapeutic vitamin C supplementation may be reasonable for pneumonia patients who have low vitamin C plasma levels because its cost and risks are low.
Subject: Antioxidants [administration & dosage]
Ascorbic Acid [administration & dosage]
Pneumonia [prevention & control]
Vitamins [administration & dosage]
Humans
COMMUNITY-ACQUIRED PNEUMONIA
RANDOMIZED CONTROLLED-TRIAL
ACUTE RESPIRATORY-INFECTIONS
ASCORBIC-ACID
COMMON COLD
OXIDATIVE STRESS
INTEROBSERVER VARIABILITY
HOSPITALIZED-PATIENTS
CHILDHOOD PNEUMONIA
CHEST RADIOGRAPHS
3121 Internal medicine
3142 Public health care science, environmental and occupational health
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