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Research

Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials

Michelle Science, Jennie Johnstone, Daniel E. Roth, Gordon Guyatt and Mark Loeb
CMAJ July 10, 2012 184 (10) E551-E561; DOI: https://doi.org/10.1503/cmaj.111990
Michelle Science
From the Division of Infectious Diseases (Science) and the Department of Paediatrics (Roth), The Hospital for Sick Children, Toronto, Ont.; and the Department of Clinical Epidemiology and Biostatistics (Science, Johnstone, Guyatt, Loeb), and the Division of Infectious Diseases and the Institute for Infectious Disease Research (Johnstone, Loeb), McMaster University, Hamilton, Ont.
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  • For correspondence: michelle.science@sickkids.ca
Jennie Johnstone
From the Division of Infectious Diseases (Science) and the Department of Paediatrics (Roth), The Hospital for Sick Children, Toronto, Ont.; and the Department of Clinical Epidemiology and Biostatistics (Science, Johnstone, Guyatt, Loeb), and the Division of Infectious Diseases and the Institute for Infectious Disease Research (Johnstone, Loeb), McMaster University, Hamilton, Ont.
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Daniel E. Roth
From the Division of Infectious Diseases (Science) and the Department of Paediatrics (Roth), The Hospital for Sick Children, Toronto, Ont.; and the Department of Clinical Epidemiology and Biostatistics (Science, Johnstone, Guyatt, Loeb), and the Division of Infectious Diseases and the Institute for Infectious Disease Research (Johnstone, Loeb), McMaster University, Hamilton, Ont.
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Gordon Guyatt
From the Division of Infectious Diseases (Science) and the Department of Paediatrics (Roth), The Hospital for Sick Children, Toronto, Ont.; and the Department of Clinical Epidemiology and Biostatistics (Science, Johnstone, Guyatt, Loeb), and the Division of Infectious Diseases and the Institute for Infectious Disease Research (Johnstone, Loeb), McMaster University, Hamilton, Ont.
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Mark Loeb
From the Division of Infectious Diseases (Science) and the Department of Paediatrics (Roth), The Hospital for Sick Children, Toronto, Ont.; and the Department of Clinical Epidemiology and Biostatistics (Science, Johnstone, Guyatt, Loeb), and the Division of Infectious Diseases and the Institute for Infectious Disease Research (Johnstone, Loeb), McMaster University, Hamilton, Ont.
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Abstract

Background: Results of randomized controlled trials evaluating zinc for the treatment of the common cold are conflicting. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of zinc for such use.

Methods: We searched electronic databases and other sources for studies published through to Sept. 30, 2011. We included all randomized controlled trials comparing orally administered zinc with placebo or no treatment. Assessment for study inclusion, data extraction and risk-of-bias analyses were performed in duplicate. We conducted meta-analyses using a random-effects model.

Results: We included 17 trials involving a total of 2121 participants. Compared with patients given placebo, those receiving zinc had a shorter duration of cold symptoms (mean difference −1.65 days, 95% confidence interval [CI] −2.50 to −0.81); however, heterogeneity was high ( I 2 = 95%). Zinc shortened the duration of cold symptoms in adults (mean difference −2.63, 95% CI −3.69 to −1.58), but no significant effect was seen among children (mean difference −0.26, 95% CI −0.78 to 0.25). Heterogeneity remained high in all subgroup analyses, including by age, dose of ionized zinc and zinc formulation. The occurrence of any adverse event (risk ratio [RR] 1.24, 95% CI 1.05 to 1.46), bad taste (RR 1.65, 95% CI 1.27 to 2.16) and nausea (RR 1.64, 95% CI 1.19 to 2.27) were more common in the zinc group than in the placebo group.

Interpretation: The results of our meta-analysis showed that oral zinc formulations may shorten the duration of symptoms of the common cold. However, large high-quality trials are needed before definitive recommendations for clinical practice can be made. Adverse effects were common and should be the point of future study, because a good safety and tolerance profile is essential when treating this generally mild illness.

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Canadian Medical Association Journal: 184 (10)
CMAJ
Vol. 184, Issue 10
10 Jul 2012
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Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials
Michelle Science, Jennie Johnstone, Daniel E. Roth, Gordon Guyatt, Mark Loeb
CMAJ Jul 2012, 184 (10) E551-E561; DOI: 10.1503/cmaj.111990

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Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials
Michelle Science, Jennie Johnstone, Daniel E. Roth, Gordon Guyatt, Mark Loeb
CMAJ Jul 2012, 184 (10) E551-E561; DOI: 10.1503/cmaj.111990
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