Standard treatment of acute diarrhoea, still one of the leading cause of death among children globally, consists of oral rehydration therapy (ORT) and zinc supplementation.
Zinc helps reduce diarrhoea’s severity and in preventing subsequent episodes. It is not fully understood though, how exactly zinc exerts its anti-diarrhoeal effect.
To find out what dosage form is best for zinc supplementation among young children suffering from acute diarrhoea, the Liaquat University Hospital in Hyberdabad, Pakistan conducted a comparative study involving 88 paediatric patients (aged six-24 months) divided into two equal groups.
Group A had dispersible zinc tablets, while Group B took zinc suspension with a dose of 20mg/day. Researchers checked for improvement by the end of the third day in terms of decrease in frequency of stools (less than 3 stools/day).
The findings revealed 51 patients showed improvement, while 37 did not. Of the 51, 32 were on the zinc tablets while 19 were taking the suspension formula.
Of the 37 patients that did not show any improvement, 12 were taking the tablets, while 25 were on the suspension formula.
“The study shows clinically important and statistically significant overall reduction of 72% in the risk of continued diarrhoea with zinc tablets compared to 43% with zinc suspension with 95% confidence interval (CI) for tablets group (0.326-1.762) and for suspension group (0.757-1.736),” researchers noted.
Meanwhile, another longitudinal cohort study among children measured the impact of daily zinc administration in different formulations.
From this study, about 90% of the patients recovered from diarrhoea within three days of presentation – 82% from tablet group and 96% from the suspension.
Researchers noted that while zinc supplementation was indeed effective in treatment of acute diarrhoea in most patients, the efficacy of zinc was more potent in suspension form.
However, zinc tablets are cheaper, and there is no need to remind mothers to shake the suspension before use, or teach them how to measure the dose properly, said researchers.
“Only 10-day course of zinc tablets are sufficient for decreasing the frequency of diarrhoea and diarrhoea-related morbidity and mortality,” researchers added.
“Our results suggest tablet form of zinc is more effective in the treatment of acute diarrhoea, but more controlled studies are needed to establish better evidence in favour of zinc tablets.”
Source: Journal of Pakistan Medical Association
“Comparison of the effectiveness of zinc supplementation in tablets form with that of the suspension form in the treatment of acute diarrhoea”
Authors: Sarwat Urooj, Hafeez UllahMemon et al.