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Vitamin D Supplementation Reduces the Risk of Acute Otitis Media in Otitis-prone Children

Marchisio, Paola MD*; Consonni, Dario MD; Baggi, Elena MD*; Zampiero, Alberto PhD*; Bianchini, Sonia MD*; Terranova, Leonardo BSc*; Tirelli, Silvia PhD; Esposito, Susanna MD*; Principi, Nicola MD*

Pediatric Infectious Disease Journal: October 2013 - Volume 32 - Issue 10 - p 1055–1060
doi: 10.1097/INF.0b013e31829be0b0
Original Studies

Background: The aim of this study was to evaluate whether a deficit in vitamin D (VD) is associated with an increased risk of recurrent acute otitis media (AOM) and whether VD supplementation is effective in reducing the number of AOM episodes in otitis-prone children.

Methods: A total of 116 children with a history of recurrent AOM (≥3 episodes in preceding 6 months or ≥4 episodes in preceding 12 months) were prospectively and blindly randomized to receive oral VD 1000 IU/d or placebo for 4 months. Episodes of AOM were monitored for 6 months.

Results: Fifty-eight children received placebo and 58 with similar characteristics were treated with VD. The number of children experiencing ≥1 AOM episode during the study period was significantly lower in the treatment group (26 versus 38; P = 0.03). There was a marked difference in the number of children who developed uncomplicated AOM (P < 0.001), but no difference in the number of children with ≥1 episode of spontaneous otorrhea. The likelihood of AOM was significantly reduced in the patients whose serum VD concentrations were ≥30 ng/mL.

Conclusions: VD hypovitaminosis is common in children with recurrent AOM and associated with an increase in the occurrence of AOM when serum 25(OH)D levels are <30 ng/mL. The administration of VD in a dosage of 1000 IU/d restores serum values of ≥30 ng/mL in most cases and is associated with a significant reduction in the risk of uncomplicated AOM.

From the *Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Epidemiology Unit, Department of Preventive Medicine, and Laboratory Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.

Accepted for publication May 14, 2013.

Supported by a grant (Ricerca Corrente 2012 850/02) from the Italian Ministry of Health to Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico. The authors have no other funding or conflicts of interest to disclose.

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Address for correspondence: Susanna Esposito, MD, Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milano, Italy. E-mail: susanna.esposito@unimi.it.

© 2013 by Lippincott Williams & Wilkins, Inc.