Date of Award
2020
Degree Type
Selective Evidence-Based Medicine Review
Degree Name
Master of Science in Health Sciences - Physician Assistant
Department
Physician Assistant Studies
Abstract
OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is oral zinc supplementation effective in reducing mortality rate in neonatal sepsis?”
STUDY DESIGN: Review of one randomized, double blind, controlled trial, one randomized controlled trial and one randomized, double blind, placebo-controlled trial published in English between 2013 and 2018.
DATA SOURCES: All three studies were gathered from peer-reviewed journals and found using PubMed.
OUTCOMES MEASURED: Patient mortality rate, defined as during hospitalization for treatment for Mehta el al. (Indian Pediatr. 2013;50(4):390-393. doi: S097475591200127 [pii]), within 1 month of birth for Newton et al. (Indian J Pediatr. 2016;83(4);289-293. doi:10.1007/s12098-015-1939-4 [doi]), and within 12 months of birth for Banupryia et al. (Indian J Pediatr. 2018;85(1):5-9. doi: 10.1007/s12098-017-2444-8 [doi]).
RESULTS: The RCT performed by Mehta et al. (Indian Pediatr. 2013;50(4):390-393. doi: S097475591200127 [pii]) showed no statistically significant reduction in the mortality rate among the septic neonates supplemented with oral zinc when compared to the placebo group (p=0.393). The mortality rate in the zinc group was 9.77% vs. 7.81% mortality rate in the placebo group. Newton et al. (Indian J Pediatr. 2016;83(4);289-293. doi:10.1007/s12098-015- 1939-4 [doi]) similarly found no statistically significant reduction in mortality rate in those septic infants treated with zinc supplementation when compared to the no zinc group (p=0.27) . The mortality rate in the zinc group was 4.5% vs. 13.6% in the no zinc group. Conversely, Banupryia et al. (Indian J Pediatr. 2018;85(1):5-9. doi: 10.1007/s12098-017-2444-8 [doi]) found a statistically significant reduction in the mortality rate among septic neonates treated with oral zinc supplementation when compared to neonates who did not receive zinc (p=0.04). The mortality rate in the zinc group was 6.6% vs. 17.3% in the no zinc group.
CONCLUSIONS: The three RCTs evaluated in this review provided conflicting evidence on whether or not oral zinc supplementation is effective in reducing mortality rate in neonatal sepsis. Mehta et al. (Indian Pediatr. 2013;50(4):390-393. doi: S097475591200127 [pii]) and Newton et al. (Indian J Pediatr. 2016;83(4);289-293. doi:10.1007/s12098-015-1939-4 [doi]) demonstrated no statistically significant reduction in mortality rate whereas Banupryia et al. (Indian J Pediatr. 2018;85(1):5-9. doi: 10.1007/s12098-017-2444-8 [doi]) did acknowledge a statistically significant reduction in mortality rate. Due to inconclusive results and limitations noted in each study, further research is needed to better evaluate the effects of zinc supplementation in reducing mortality rate in neonatal sepsis.
Recommended Citation
Smucker, Abigail R., "Is Oral Zinc Supplementation Effective In Reducing Mortality Rate In Neonatal Sepsis?" (2020). PCOM Physician Assistant Studies Student Scholarship. 533.
https://digitalcommons.pcom.edu/pa_systematic_reviews/533