Effect of vitamin D supplementation on antibiotic use: a randomized controlled trial

Am J Clin Nutr. 2014 Jan;99(1):156-61. doi: 10.3945/ajcn.113.063271. Epub 2013 Oct 9.

Abstract

Background: Observational data suggested that supplementation with vitamin D could reduce risk of infection, but trial data are inconsistent.

Objective: We aimed to examine the effect of oral vitamin D supplementation on antibiotic use.

Design: We conducted a post hoc analysis of data from pilot D-Health, which is a randomized trial carried out in a general community setting between October 2010 and February 2012. A total of 644 Australian residents aged 60-84 y were randomly assigned to receive monthly doses of a placebo (n = 214) or 30,000 (n = 215) or 60,000 (n = 215) IU oral cholecalciferol for ≤12 mo. Antibiotics prescribed during the intervention period were ascertained by linkage with pharmacy records through the national health insurance scheme (Medicare Australia).

Results: People who were randomly assigned 60,000 IU cholecalciferol had nonsignificant 28% lower risk of having antibiotics prescribed at least once than did people in the placebo group (RR: 0.72; 95% CI: 0.48, 1.07). In analyses stratified by age, in subjects aged ≥70 y, there was a significant reduction in antibiotic use in the high-dose vitamin D compared with placebo groups (RR: 0.53; 95% CI: 0.32, 0.90), whereas there was no effect in participants aged <70 y (RR: 1.07; 95% CI: 0.58, 1.97) (P-interaction = 0.1).

Conclusion: Although this study was a post hoc analysis and statistically nonsignificant, this trial lends some support to the hypothesis that supplementation with 60,000 IU vitamin D/mo is associated with lower risk of infection, particularly in older adults. The trial was registered at the Australian New Zealand Clinical Trials Registry (anzctr.org.au) as ACTRN12609001063202.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Cholecalciferol / administration & dosage*
  • Dietary Supplements*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • New Zealand
  • Pilot Projects
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology*
  • Treatment Outcome
  • Vitamins / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Vitamins
  • Cholecalciferol