Zinc With Oral Rehydration Therapy Reduces Stool Output and Duration of Diarrhea in Hospitalized Children: A Randomized Controlled Trial

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Abstract
The authors evaluated the effect of zinc treatment as an adjunct to oral rehydration therapy on stool output and diarrheal duration in children with acute noncholera diarrhea with dehydration. This double-blind, randomized, controlled trial was conducted at two urban hospitals in New Delhi. A total of 287 dehydrated male patients, ages 3 to 36 months, with diarrhea for ≤ 72 hours were enrolled. They were assigned to zinc or placebo by a randomization scheme stratified by age (≤ or >12 months) and weight for height (65%–80% or >80% National Centre for Health Statistics median). Participants in the zinc group received 15 mg (≤12 months) or 30 mg (>12 months) elemental zinc daily in three divided doses for 14 days. The main outcome measures were stool output and diarrheal duration. Zinc treatment reduced total stool output (ratio of geometric means, 0.69; 95% confidence interval [CI]: 0.48, 0.99) and stool output per day of diarrhea (ratio of geometric means, 0.76; 95% CI: 0.59, 0.98). The risk of continued diarrhea was lower (relative hazards, 0.76; 95% CI: 0.59, 0.97) and the proportion of diarrheal episodes lasting ≥ 5 days (odds ratio, 0.49; 95% CI: 0.25, 0.97) or ≥ 7 days was less (odds ratio, 0.09; 95% CI: 0.01, 0.73) in the zinc group. This study demonstrates a beneficial effect of zinc administered during acute diarrhea on stool output, diarrheal duration, and proportion of episodes lasting more than 7 days. The effects are large enough to merit routine use of zinc during acute diarrhea in developing countries.