Background: People who are hospitalized for any reason are also at high risk for pneumonia, Supplemental zinc provides therapeutic benefits in pneumonia. Objectives: To evaluate the role of zinc supplementation in the recovery of hospitalized children with pneumonia. Patients & Methods : Randomized control study was conducted at Karbala pediatric teaching hospital between March ,2019 – September, 2020. Inpatient children aged 3m-60m who presented with pneumonia were enrolled and divided into 2 groups , zinc group (93 case) who receive zinc, the male was 51 patient and female was 42 patient, and control group (82 case ) male was 47 patient and the female was 35 patient. Zinc is given according to WHO guideline, 20mg for children above 6 mo age and 10 mg below 6mo age. for all patient CXR, CBC, oxygen saturation and RR were measured. Results: clinically and statistically reduction in recovery time from severe pneumonia and overall hospital stay in children from 3 month to 5 years whom given zinc sulphate with standard antimicrobial therapy.   The total days of admission for zinc group was (397 days and mean of 4.2) versus (429 days and the mean of 5.2 days) of control group this indicate that zinc treatment has a direct effect to decrease duration of admission , so children who received zinc supplementation during pneumonia episode who had improvement within 5 days is (89.2%) versus (56 %) improvement of control group with p value of (0.0003), and This result is supported by other 2 trials done one in India (rate of recovery was 2.6 time and P value was 0.004),As well as patient response was more prolong in control group and more severe cases were related to this group compared with zinc group. Also current study show that there is a good response in breast feed zinc group in comparism to breast feed control group, which had improvement of (46.2% versus 34.1%) within 5 days. the difference in response to zinc in bottle feeding infant and the result was 24.7% for zinc group and 19.5 for control group and the small difference in response may be attributed to that the presence of calcium in milk in high concentration is known to decrease zinc absorption from intestine by competition.So , the same response to zinc supplementation between male and female in the first 5 days of treatment and the result was (90.4% and 87.8% respectively). Conclusion: The use of zinc sulfate in the management of acute lower respiratory tract infection is effective in decrease both severity and duration of illness.Also Zinc therapy is effective in both male and female.

Keywords: zinc supplementation; recovery; hospitalized children; pneumonia