A Randomized Comparison Between Daily, Alternate Day and Weekly Single Dose Oral Iron Therapy in Children With Iron Deficiency Anemia

The aim of this study was to compare the effectiveness of oral iron therapy administered daily, alternate day, and weekly in children with iron deficiency anemia (IDA). Children (1 to 16 y) diagnosed with IDA were included. Patients (n: 135; M/F: 1.2) were randomized to 3 regimens of oral iron (single dose) for 12 weeks: weekly (group 1), alternate day (group 2), and daily (group 3). The groups were similar in terms of age, sex, weight, and height at baseline. Mean hemoglobin increased from 11.0±1.3 to 11.5±1.2 g/dL in group 1, from 10.6±0.6 to 11.6±0.7 g/dL in group 2, and from 9.5±1.4 to 11.9±1.1 g/dL in group 3. Mean percentage increases in hemoglobin in groups 1, 2, and 3 were 4.5%, 9.8%, and 27.5% at 12 weeks. Hemoglobin levels were similar in all groups at the end of treatment, although significantly lower levels of baseline hemoglobin were observed in the daily treatment group. Anemia persisted in 53.3%, 37.8%, and 26.7% of patients at 12 weeks in groups 1, 2, and 3, respectively. Mean ferritin increased from 6.9±2.6 to 9.4±3.9ng/mL, from 7.0±2.2 to 25.6±8.0ng/mL, and from 5.8±2.47 to 32.3±15.7ng/mL in groups 1, 2 and 3, respectively. We conclude that anemia was resolved best in single daily dose treatment followed by alternate day and weekly therapy in children with IDA.