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Pham H, Waterhouse M, Baxter C, Romero BD, McLeod DSA, Armstrong BK, Ebeling PR, English DR, Hartel G, Kimlin MG, O'Connell RL, van der Pols JC, Venn AJ, Webb PM, Whiteman DC, Neale RE. Vitamin D supplementation and antibiotic use in older Australian adults - an analysis of data from the D-Health Trial. J Infect Dis 2022; 226:949-957. [PMID: 35780325 DOI: 10.1093/infdis/jiac279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 11/12/2022] Open
Abstract
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% CI 0.95-1.01), total prescriptions (IRR 0.97, 95% CI 0.93-1.00), and repeat prescription episodes (IRR 0.96, 95% CI 0.93-1.00). There was stronger evidence of benefit in people predicted to have insufficient vitamin D at baseline (prescription episodes IRR 0.93, 95% CI 0.87-0.99). 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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Affiliation(s)
- Hai Pham
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,School of Public Health, the University of Queensland, Brisbane, Australia
| | - Mary Waterhouse
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Catherine Baxter
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Briony Duarte Romero
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Donald S A McLeod
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Bruce K Armstrong
- School of Public Health, University of Sydney, Sydney, Australia and School of Population and Global Health, University of Western Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Dallas R English
- Melbourne School of Population Health, University of Melbourne.,Cancer Epidemiology Division, Cancer Council Victoria, Melbourne Australia
| | - Gunter Hartel
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Michael G Kimlin
- School of Biomedical Sciences, Queensland University of Technology, Australia
| | | | - Jolieke C van der Pols
- Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Australia
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,School of Public Health, the University of Queensland, Brisbane, Australia
| | - David C Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,School of Public Health, the University of Queensland, Brisbane, Australia
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