4.7 Article

Vitamin D Supplementation and Antibiotic Use in Older Australian Adults: An Analysis of Data From the D-Health Trial

Journal

JOURNAL OF INFECTIOUS DISEASES
Volume 226, Issue 6, Pages 949-957

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiac279

Keywords

antibiotic use; vitamin D supplementation; randomized controlled trial; urinary tract infection

Funding

  1. National Health and Medical Research Council (NHMRC) [GNT1046681, GNT1120682]
  2. NHMRC [GNT1197958, GNT1060183, GNT1173346, GNT1155413]
  3. Metro North Clinician Research Fellowship (Metro North Hospital andHealth Service)
  4. Queensland Advancing Clinical Research Fellowship (Queensland Government)
  5. University of Queensland PhD Scholarship
  6. Western Australian State Government
  7. Australian Federal Government, through Bioplatforms Australia
  8. National Collaborative Research Infrastructure Strategy

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This study analyzed the effect of vitamin D supplementation on infection risk and found that vitamin D may reduce the number of antibiotic prescriptions, especially in individuals with low vitamin D levels.
Background. Vitamin D supplementation may reduce the risk or severity of infection, but this has been investigated in few large population-based trials. We analyzed data from the D-Health Trial, using prescription of antibiotics as a surrogate for infection. Methods. The D-Health Trial is a randomized, double-blind, placebo-controlled trial in which 21 315 Australians aged 60-84 years were randomized to 60 000 IU of supplementary vitamin D-3 or placebo monthly for 5 years. For this analysis, the primary outcome was the number of antibiotic prescription episodes; secondary outcomes were total number of prescriptions, repeat prescription episodes, and antibiotics for urinary tract infection. We estimated incidence rate ratios (IRRs) using negative binomial regression, and odds ratios using logistic regression. Results. Vitamin D supplementation slightly reduced the number of prescription episodes (IRR, 0.98; 95% confidence interval [CI], .95-1.01), total prescriptions (IRR, 0.97; 95% CI, .93-1.00), and repeat prescription episodes (IRR, 0.96; 95% CI, .93-1.00). There was stronger evidence of benefit in people predicted to have insufficient vitamin D at baseline (prescription episodes IRR, 0.93; 95% CI, .87-.99). Conclusions. Vitamin D may reduce the number of antibiotic prescriptions, particularly in people with low vitamin D status. This supports the hypothesis that vitamin D has a clinically relevant effect on the immune system.

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