Zinc Gluconate Lozenges for Treating the Common Cold in Children

A Randomized Controlled Trial

Macknin, Michael L. MD
Piedmonte, Marion MA
Calendine, Cory BS
Janosky, Janine PhD
Wald, Ellen MD

From the Departments of Pediatrics and Adolescent Medicine (Dr Macknin and Mr Calendine) and Biostatistics and Epidemiology (Ms Piedmonte), Cleveland Clinic Foundation, Cleveland, Ohio, and the Departments of Family Medicine and Clinical Epidemiology (Dr Janosky) and Pediatrics (Dr Wald), University of Pittsburgh School of Medicine, Pittsburgh, Pa.

JAMA: The Journal of the American Medical Association 279(24):p 1962-1967, June 24, 1998.

Context

The common cold is one of the most frequently occurring illnesses and is responsible for substantial morbidity and economic loss. Biochemical evidence suggests that zinc may be an effective treatment, and zinc gluconate glycine (ZGG) lozenges have been shown to reduce the duration of cold symptoms in adults.

Objective

To determine the efficacy of ZGG treatment of colds in children and adolescents.

Design

A randomized, double-masked, placebo-controlled study.

Setting

Two suburban school districts in Cleveland, Ohio.

Patients

A total of 249 students in grades 1 through 12 were enrolled within the first 24 hours of experiencing at least 2 of 9 symptoms of the common cold.

Intervention

Zinc lozenges, 10 mg, orally dissolved, 5 times a day (in grades 1-6) or 6 times a day (in grades 7-12).

Main Outcome Measures

Time to resolution of cold symptoms based on subjective daily symptom scores for cough, headache, hoarseness, muscle ache, nasal congestion, nasal drainage, scratchy throat, sore throat, and sneezing.

Results

Time to resolution of all cold symptoms did not differ significantly between students receiving zinc (n=124) and those receiving placebo (n=125) (median, 9 days; 95% confidence interval [CI], 8-9 days; median, 9 days, 95% CI, 7-10 days, respectively; P=.71). There were no significant differences in the time to resolution of any of the 9 symptoms studied. Compared with controls, more students in the zinc group reported adverse effects (88.6% vs 79.8%; P =.06); bad taste (60.2% vs 37.9%; P=.001); nausea (29.3% vs 16.1%; P=.01); mouth, tongue, or throat discomfort (36.6% vs 24.2%; P =.03); and diarrhea (10.6% vs 4.0%; P=.05).

Conclusions

In this community-based, randomized controlled trial, ZGG lozenges were not effective in treating cold symptoms in children and adolescents. Further studies with virologic testing are needed to clarify what role, if any, zinc may play in treating cold symptoms.

JAMA.1998;279:1962-1967