Diarrhea prevalence on days 3 , 5 , and 7 was lower in the zinc group .
The incidence of vomiting was significantly greater in the group that received zinc than in the control group .
CONCLUSIONS Oral zinc supplementation significantly decreases diarrhea duration and has a greater effect on malnourished children .
OBJECTIVE To up date the available evidence about zinc use for treating diarrhea in children and to assess its effect on the malnourished population , a subgroup that has not been fully explored in previous analyses .
Zinc Supplementation in Acute Diarrhea is Acceptable, Does Not Interfere with Oral Rehydration, and Reduces the Use of Other Medications: A Randomized Trial in Five Countries
Objective : Assess the impact of zinc supplementation with locally developed culturally specific educational statements ( messages ) on oral rehydration solution ( ORS ) and antibiotics or antidiarrheal use in children with acute watery diarrhea as well as to assess adherence and side effects of zinc . Methods : This was a r and omized effectiveness trial conducted in outpatient health facilities of six sites in five countries , namely , Fortaleza ( Brazil ) , Addis Adaba ( Ethiopia ) , Cairo ( Egypt ) , Lucknow and Nagpur ( India ) , and Manila ( Philippines ) . Participants were 2,002 children aged 2 to 59 months . Intervention was zinc ( 20 mg orally , once daily for 14 days ) with ORS ( zinc group ) compared with ORS alone ( control group ) . Primary outcomes were  ORS use on day 3 to 5 ; adherence to zinc ; and any use of an antibacterial/antidiarrheal up to day 14 . Results : One thous and ten and 992 children enrolled in zinc and control groups , respectively . Loss to follow-up on days 3 to 5 and 15 to 17 was 1.2 % and 2.8 % in the zinc group and 0.8 % and 1.7 % in the control group . In five of six sites , ORS use in cases with continued diarrhea on days 3 to 5 was the same in the two groups or higher in zinc group . Overall adherence to zinc supplementation was 83.8 % ( 95 % confidence interval [ CI ] 81 - 86 ) . There was no difference in vomiting by group . In consideration of the six countries overall , less antibiotic/antidiarrheal use occurred in the zinc group ( absolute difference , 3.8 % [ 95 % CI 1.7 - 5.9 ] ) . Conclusions : In the management of acute watery diarrhea , zinc plus ORS along with culturally appropriate , site-specific messages in local language does not affect overall  ORS  use generally and decreases antibiotic/antidiarrheal use ; children had good adherence without side effects
Diarrhea prevalence on days 3 , 5 , and 7 was lower in the zinc group .
The incidence of vomiting was significantly greater in the group that received zinc than in the control group .
CONCLUSIONS Oral zinc supplementation significantly decreases diarrhea duration and has a greater effect on malnourished children .
OBJECTIVE To up date the available evidence about zinc use for treating diarrhea in children and to assess its effect on the malnourished population , a subgroup that has not been fully explored in previous analyses .