Study

Supplementation

Schedule

Antibiotic

Definition of clinical recovery

Discharge criteria

Zinc

Placebo

Bansal 2011

Zinc gluconate 20 mg

Placebo

Daily

Parenteral antibiotic

Time to be asymptomatic was defined as resolution of all four of the following symptoms: 1) danger signs; 2) respiratory distress; 3) tachypnoea and 4) hypoxia in room air, for at least 24 h

Children were discharged from hospital when they were asymptomatic for at least 24 h

Bose 2006

Zinc sulphate

20 mg

Placebo

Daily

Inj. benzyl penicillin + gentamicin

Resolution of the following: 1) respiratory rate 50 breaths/min and oxygen saturation 93%; 2) inability to drink, respiratory rate 50 breaths/min, and oxygen saturation 93%; and 3) chest indrawing, respiratory rate 50 breaths/min and oxygen saturation 93% for at least 16 h

Children were discharged when they were being fed entirely with oral feeds, the respiratory rate was 50 breaths/min, oxygen saturation was 93%, and the attending paediatrician decided that the patient’s clinical condition had resolved and did not require further hospital care

Brooks 2004

Zinc acetate

20 mg

Placebo

Daily

Inj. ampicillin + gentamicin

Resolution of the following: 1) chest indrawing; 2) respiratory rate more than 50 per min; and 3) hypoxia (oxygen saturation <95%) for at least 24 h

Children were discharged from hospital once respiratory rate fell to less than or equal to 40 breaths per min for 24 consecutive h, with no recurrence of respiratory distress, other danger signs, or fever (temperature > 37·9°C)

Valentiner‐Branth 2010

Zinc sulphate

10 mg for < 12 months

and 20 mg for > 12 months

Placebo

Twice daily

Oral co‐trimoxazole for non‐severe pneumonia

benzyl penicillin for severe pneumonia

Recovery was defined as the beginning of the first 24 h period without LCI, without grunting and with no nasal flaring for at least 24 h

The child was considered for discharge when he/she recovered from severe pneumonia

Study

Outcome

Zinc group

Placebo group

Bansal 2011 Median (IQR)

Time to be asymptomatic (h)

60 (24, 78)

54 (30, 72)

Time to resolution of respiratory distress (h)

30.5 (16, 48)

24 (13, 48)

Time to resolution of tachypnoea (h)

60 (24, 72)

48 (24, 72)

Time to disappearance of danger signs (h)

20 (8, 36)

16 (8, 30)

Valentiner‐Branth 2010 Median (IQR)

Time to recovery from severe pneumonia (d)

2 (1, 3)

2 (1, 3)

Time to recovery (d)

4 (2, 7)

3 (2, 6)

Time to discharge from hospital (d)

3 (3, 4)

3 (3, 4)

Bose 2006 Median (95% CI)

Time to be asymptomatic (h)

(Inability to feed, O² saturation < 93%, RR > 50)

(Chest indrawing, O² saturation  <93%, RR > 50)

(O² saturation  <93%, RR > 50)

87.2 (70.7, 95.2)

111.3 (88.5, 138.0)

82.2 (70.3, 92.2)

76.2 (72.3, 88.1)

96.7 (78.2, 112.9)

75.9 (71.2, 88.0)

Time to resolution of tachypnoea (RR > 50) (h)

72.0 (68.5, 88.0)

73.0 (64.5, 82.8)

Hospitalisation (h)

71.1  (68.1, 87.3)

72.3 (67.7, 79.6)

Brooks 2004 Median (95% CI)

Time to recovery from severe pneumonia (h)

72 (72, 96)

96 (72, 96)

Chest indrawing

40 (39, 48)

48 (40, 56)

Hospital stay (d)

112 (104, 112)

112 (111, 129)