Daily versus alternate day oral iron treatment for children with nutritional iron deficiency anemia

BACKGROUND: Iron deficiency anemia (IDA) in children poses significant health risks, necessitating effective treatment strategies. While daily oral iron therapy is standard, alternate-day therapy has emerged as a potential alternative to improve compliance and minimize side effects. This study aimed to compare the efficacy of daily and alternate-day iron supplementation in children with IDA. METHODS: This retrospective cohort study included 82 children with nutritional IDA receiving either daily (42 patients) or alternate-day (40 patients) oral ferrous sulfate therapy. Hematologic and iron parameters, including hemoglobin (Hb), ferritin, and total iron-binding capacity (TIBC), were evaluated at baseline, day 10, 1, and 3 months. Statistical analyses were performed using SPSS, with p ≤ 0.05 considered significant. RESULTS: No significant differences in Hb changes were observed based on the treatment regimens. When comparing Hb changes from diagnosis to the first month and from the first month to the third month, a significant increase was noted in the daily therapy group during the first month. At the beginning of the study, the mean corpuscular volume (MCV) values were higher in the alternate-day group, while the red cell distribution width (RDW) values at diagnosis were greater in the daily group. Throughout the first and third months, MCV and RDW values were similar between the two groups. Additionally, ferritin and TIBC levels showed no significant differences over the study period. CONCLUSIONS: Alternate-day oral iron therapy is as effective as daily therapy in managing pediatric IDA, offering a viable alternative with similar hematologic and iron parameter improvements.