Role of Zinc Supplementation in Preterm Neonates with Sepsis

Abstract

Objective: Objective of the study was to assess the role of zinc in addition to antibiotics in reducing mortality &morbidity in preterm neonatal sepsis. Study Design: Prospective randomized controlled trial. Place and Duration of Study: Neonatal unit of Department of Pediatric Medicine, Jinnah hospital Lahore. The study duration was 10 months, from 1 January 2021 to 31 October 2021. Materials and Methods: We enrolled 260preterm babies who had clinical findings of sepsis and positive blood investigations fulfilling the preset criteria. The intervention group was given zinc sulfate monohydrate at a dose 2mg/kg/day orally 2 times a day for 10 days with empirical antibiotics while the control group received empirical antibiotic treatment (Ampicillin & Amikacin) only without addition of zinc. Blood samples were withdrawn for laboratory investigations like complete blood count, CRP & blood culture & sensitivity from the two groups at days 0, 2, 5 & 10 of start of intervention. We compared both groups with the help of a predefined sepsis score including both clinical and laboratory data. Percentages were calculated to measure the outcomes in both groups to show the difference of CRP level and mortality. Demographic variables including weight in kilograms and age of gestation in weeks were mentioned in mean ± SD (standard deviation). Results: Only 34% of blood cultures were organism positive, including Staphylococcus aureus, E.coli, Klebsiella Acinetobacter, Streptococcus, Pseudomonas and Candida. CRP levels before start of zinc therapy were comparable in both groups; while at day 5 and day 10 of zinc therapy, there was a relative decline in blood CRP level in intervention group. Mortality was 19% in the group with zinc addition as compared to the other group(25%) with no zinc supplementation. Conclusion: Zinc supplementation along with antibiotics decreases morbidity (septic shock, seizures, organ dysfunction, metabolic acidosis, respiratory distress/apnea, feeding issues) and mortality in preterm babies with neonatal sepsis.

Keywords

• infections, low-birth weight, newborns, prematurity, zinc