TY - JOUR
T1 - Vitamin D Supplementation and Antibiotic Use in Older Australian Adults: An Analysis of Data From the D-Health Trial
AU - Pham, Hai
AU - Waterhouse, Mary
AU - Baxter, Catherine
AU - Duarte Romero, Briony
AU - McLeod, Donald S.A.
AU - Armstrong, Bruce K.
AU - Ebeling, Peter R.
AU - English, Dallas R.
AU - Hartel, Gunter
AU - Kimlin, Michael G.
AU - O'Connell, Rachel L.
AU - Van Der Pols, Jolieke C.
AU - Venn, Alison J.
AU - Webb, Penelope M.
AU - Whiteman, David C.
AU - Neale, Rachel E.
N1 - Funding Information:
This work was supported by National Health and Medical Research Council (NHMRC) (grant numbers GNT1046681 and GNT1120682). P. R. E., R. E. N., P. M. W., and D. C. W. are/were supported by fellowships from the NHMRC (grant numbers GNT1197958, GNT1060183, GNT1173346, and GNT1155413). D. S. A. M. is supported by a Metro North Clinician Research Fellowship (Metro North Hospital andHealth Service) and Queensland Advancing Clinical Research Fellowship (Queensland Government). H. P. is supported by a University of Queensland PhD Scholarship. The vitamin D assays was performed at the University of Western Australia, supported by infrastructure funding from the Western Australian State Government in partnership with the Australian Federal Government, through Bioplatforms Australia and the National Collaborative Research Infrastructure Strategy.
Funding Information:
Potential conflicts of interest. R. E. N. has received funding from Viatris for an unrelated study of pancreatic cancer. P. M. W. has received funding from Astra Zeneca for an unrelated study of ovarian cancer. P. R. E. reports grants from Amgen, grants from Sanofi, and grants from Alexion. All other authors declare no potential conflicts of interests.
Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.
PY - 2022/9/15
Y1 - 2022/9/15
N2 - 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 D3 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.Clinical Trials Registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000743763. https://www.anzctr.org.au/.
AB - 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 D3 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.Clinical Trials Registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000743763. https://www.anzctr.org.au/.
UR - http://www.scopus.com/inward/record.url?scp=85138458024&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiac279
DO - 10.1093/infdis/jiac279
M3 - Article
C2 - 35780325
AN - SCOPUS:85138458024
SN - 0022-1899
VL - 226
SP - 949
EP - 957
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 6
ER -