Oral versus Intramuscular Route of Administration of Vitamin D Supplementation in Pediatric Population
Fouzia Aijaz Shaikh, Salma Shaikh, Naila Masood Siddiqui, Imran Ali Shaikh, Talha Ali Shaikh, Javairia Shaikh
Background: Deficiency of vitamin d can lead to a number of serious long-term health problems. The current study determined the optimum route of vitamin D administration in children.
Methodology: This was a longitudinal study conducted at the Pediatrics Department, Liaquat University of medical and health sciences (LUMHS), Jamshoro. All children aged between 1 to 5 years were eligible to take part in the study. 2cc of the blood sample was extracted from the vein over the dorsum of the left hand and sent to the research laboratory for examining Vitamin D level. The vitamin D levels were measured at baselines, 4th month, and 12th month of treatment. After enrollment, children were divided equally into two groups, Group A and Group B. Group A received a dose of 600,000 U injection intramuscularly at 0, 4th, and 12 months and group B, received a dose of 600,000 U orally on 0, 4, and 12 months by ampoule. Serial vitamin D estimation was done at 0, 4, and 12 months. All data were collected on a pre-designed study proforma.
Results: It was found that both routes of vitamin D administration were equally effective. Patients who were administered vitamin D via intramuscular route had significant improvements by the fourth month as compared to the baseline levels (11.4 ± 3.4 vs 33.5 ± 6.7, p<0.001). Similarly, the mean baseline levels in patients who were administered the supplements orally were significantly increased by the fourth month (p<0.001). We found no correlation between different age groups and severity of deficiency at different intervals of time. The majority of the patients by the fourth month of treatment reached the peak range of vitamin D however, many reverted back to mild to moderate deficiency by the twelfth month. Upon assessing the adverse effects of the two routes, it was found that the oral route was significantly associated with increased rates of vomiting as compared to the intramuscular route [16 (20.51%) vs 8 (10.26%), p<0.001].
Conclusion: We revealed that both oral and intramuscular routes of administration of vitamin D were efficacious and successfully attained peaks by the fourth month of treatment. Only a few children experienced vomiting, pain on site of injection, and abdominal pain after receiving their dose of medication. It is recommended that the intramuscular route should be preferred in cases where children are suspected of malabsorption.
Keywords: Hypovitaminosis, Children, Vitamin D, Vitamin D deficiency, Vitamin D supplementation, Route