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Giving zinc to children with diarrhoea reduces its severity and duration. Now a study in Bangladesh (BMJ 2008;336:266–8; see also editorial, ibid: 227–8) has demonstrated that zinc is also indicated as part of the treatment of cholera in children. A total of 179 children aged 3–14 years with bacteriologically proven cholera were treated with erythromycin and randomised to zinc acetate or placebo. After 3 days, 81% in the zinc group and 68% in the placebo group had recovered. Zinc reduced the duration of diarrhoea and stool volume by 11–12%. The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) already recommend zinc supplementation for all children with diarrhoea.
An international trial comparing nasal continuous positive airway pressure (CPAP) with intubation and ventilation for the resuscitation of very preterm infants (New England Journal of Medicine 2008;358:700–8) has not shown a reduction in overall mortality or the incidence of bronchopulmonary dysplasia (BPD) with CPAP. The trial included a total of 610 infants born at 25–28 weeks and breathing spontaneously but needing respiratory support at 5 minutes. When the infants reached 36 weeks gestational age there was no significant difference between the two groups in the combined endpoint of death or BPD (34% with CPAP, 39% with intubation). At 28 days postnatal age there was a significant …
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