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Antibiotic use cut in half by elderly (over 70) after monthly 60,000 IU of vitamin D – RCT Dec 2013

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

Am J Clin Nutr December 2013 ajcn.063271
Bich Tran, Bruce K Armstrong, Peter R Ebeling, Dallas R English, Michael G Kimlin, Jolieke C van der Pols, Alison Venn, Val Gebski, David C Whiteman, Penelope M Webb, and Rachel E Neale
1 From the Population Health Department, Queensland Institute of Medical Research, Brisbane, Queensland, Australia (BT, DCW, PMW and REN); the Centre for Research Excellence in Sun and Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia (BT, MGK, DCW and REN); the School of Population Health, University of Queensland, Brisbane, Queensland, Australia (JCvdP); the Sydney School of Public Health (BKA) and the National Health and Medical Research Council of Australia Clinical Trials Centre, Sydney Medical School (VG), University of Sydney, Camperdown, New South Wales, Australia; Northwest Academic Centre, University of Melbourne, and Western Health, Melbourne, Victoria, Australia (PRE); the School of Population Health, University of Melbourne, Parkville, Victoria, Australia (DRE); the AusSun Research Laboratory, Queensland University of Technology, Kelvin Grove, Queensland, Australia (MGK); and the Menzies Research Institute Tasmania, Hobart, Tasmania, Australia (AV).
↵2 The National Health and Medical Research Council of Australia had no role in the study design, protocol development, trial conduct, data collection or analysis, or interpretation of results.
↵3 Supported by the National Health and Medical Research Council of Australia (NHMRC) (grant 613655 and fellowships to PMW, REN, and AV), the Australian Research Council (a future fellowship to DCW), the Cancer Council Queensland (senior research fellowship to MGK), and the NHMRC Centre for Research Excellence in Sun and Health (postdoctoral research fellowship to BT). The investigational product was supplied free of charge by sanofi-aventis healthcare pty ltd trading as Sanofi Consumer Healthcare.
↵4 Address reprint requests and correspondence to R Neale, Queensland Institute of Medical Research, 300 Herston Road, Herston, Brisbane, Queensland 4006, Australia. E-mail: rachel.neale at qimr.edu.au.

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 <70 y old (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.

Cited by 53 studies as of June 2021

  • Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis -June 2020? https://eprints.utas.edu.au/33168 FREE PDF
  • High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: A Randomized Clinical Trial - https://doi.org/10.1111/jgs.14679 Nov 2016 FREE PDF
    • 100,000 monthly helped, even though average vitamin D level was only 32 ng
    • Should have used larger or more frequent doses to get the average up to say 40 ng

Most likely would have used even less use of antibiotics if:

  1. Had doubled the vitamin D dose - say 60,000 IU every two weeks
  2. Also treated with Magnesium - which increases the response to vitamin D
    Mg may independently improve the immune system

Personal Observation by admin of VitaminDWiki

My 101 year-old father-in-law has not has a single bacterial infection in the 2 years since he started taking 6X as much vitamin D as was used in this RCT (12,000 IU daily)
He also has been taking 500 mg of Magnesium daily.

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