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Reduced osmolarity oral rehydration solution for persistent diarrhea in infants: a randomized controlled clinical

S A Sarker1, D Mahalanabis, N H Alam

  • 1Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

The Journal of Pediatrics
|April 11, 2001
PubMed

Insights

Reduced osmolarity oral rehydration solutions (ORS) significantly decreased stool volume and frequency in infants with persistent diarrhea compared to the standard WHO-ORS. These reduced osmolarity ORS formulations demonstrated improved clinical effectiveness and faster diarrhea resolution.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Infectious Diseases

Background:

  • Persistent diarrhea in infants poses a significant health risk, often requiring specialized hydration strategies.
  • The World Health Organization (WHO) oral rehydration solution (ORS) is a standard treatment, but its efficacy in persistent diarrhea is debated.
  • Reduced osmolarity ORS formulations have been developed to potentially improve fluid absorption and reduce stool output.

Purpose of the Study:

  • To compare the clinical efficacy of the standard WHO-ORS with two reduced osmolarity ORS formulations in infants experiencing persistent diarrhea.
  • To evaluate the impact of different ORS formulations on stool volume, frequency, ORS intake, and diarrhea resolution.

Main Methods:

  • A randomized controlled trial involving 95 infants with persistent diarrhea.
  • Infants were assigned to receive either WHO-ORS, a glucose-based reduced osmolarity ORS (RORS-G), or a rice-based reduced osmolarity ORS (RORS-R) for up to 7 days.
  • Key outcome measures included stool volume and frequency, ORS consumption, and time to diarrhea resolution.

Main Results:

  • Reduced osmolarity ORS groups showed approximately 40% less stool volume compared to the WHO-ORS group.
  • Children receiving reduced osmolarity ORS required significantly less ORS (22% for RORS-G, 27% for RORS-R).
  • A higher proportion of infants in the RORS-R group experienced diarrhea resolution; no cases of hyponatremia were observed.

Conclusions:

  • Reduced osmolarity ORS is clinically more effective than the standard WHO-ORS for treating persistent diarrhea in infants.
  • These findings suggest that reduced osmolarity ORS formulations offer advantages in managing persistent diarrhea, potentially leading to quicker recovery.
  • The safety profile was confirmed, with no instances of hyponatremia across all treatment arms.
Abstract

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