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Control study of oral rehydration solution (ORS)/ORS + dioctahedral smectite in hospitalized Thai infants with acute
B Vivatvakin1, S Jongpipatvanich, S Harikul
1Department of Pediatrics, Chulalongkorn University Hospital, Bangkok, Thailand.
Insights
Dioctahedral smectite significantly shortened acute secretory diarrhea duration in infants. This antidiarrheal agent, when combined with oral rehydration solution, proved safe and effective in reducing diarrhea course in young children.
Area of Science:
- Gastroenterology
- Pediatrics
- Pharmacology
Background:
- Dioctahedral smectite is a non-systemic antidiarrheal agent with mucoprotective properties.
- It effectively absorbs enterotoxins and rotavirus, as evidenced in animal models.
- Smectite has a history of successful use in treating acute diarrhea in children and adults globally.
Purpose of the Study:
- To evaluate the efficacy of smectite combined with oral rehydration solution (ORS) in treating acute secretory diarrhea in infants.
- To assess the impact of smectite on diarrhea duration, frequency, and infant recovery.
Main Methods:
- A randomized study involving 62 hospitalized Thai infants (1-24 months) with acute secretory diarrhea.
- Infants were divided into two groups: one receiving ORS alone, the other receiving ORS plus smectite (3.6 g/day).
- Data collected included stool frequency, weight changes, and duration of diarrhea. Standard lactose-free diet was provided to all participants.
Main Results:
- The mean duration of diarrhea was significantly shorter in the smectite group (43.3 hours) compared to the ORS-only group (84.7 hours) (p=0.005).
- Fewer infants in the smectite group experienced prolonged diarrhea, with only 3% still having diarrhea on Day 5 versus 27% in the control group.
- No significant differences were observed in stool frequency or weight changes between the groups. Mild side effects like vomiting and hardened stools were noted in a few cases.
Conclusions:
- Dioctahedral smectite effectively shortens the duration of acute secretory diarrhea in Thai infants.
- Smectite administration may help reduce the incidence of prolonged diarrhea in this age group.
- The study confirms the safety of dioctahedral smectite for children aged 1 to 24 months when used as an adjunct to rehydration therapy.
Abstract:
Dioctahedral smectite, a non systemic antidiarrheal agent, is mucoprotective and absorbs enterotoxins and rotavirus as demonstrated in animal models. Smectite has been successfully used in various countries in children and adults with acute diarrhea. This study was to assess the efficiency of smectite associated with rehydration in infants with acute secretory diarrhea. Sixty-two hospitalized Thai infants, aged 1-24 months, with acute secretory diarrhea were randomly divided into 2 groups receiving (1) oral rehydration solution (ORS) (30 cases), (2) ORS and Smectite (3.6 g/day) (32 cases). Both groups were comparable for age, weight, nutritional status and duration of symptoms before treatment. All 62 infants received lactose free formula and chicken rice soup as the standard diet. Stool frequency, weight change and duration of diarrhea were recorded. The mean duration of diarrhea was 84.7 +/- 48.5 hours in group 1, and 43.3 +/- 25.1 hours in group 2 (p = 0.005). The number of infants with diarrhea was significantly lower in group 2 on Day 1 (p < 0.01) and Day 3 (p = 0.001); furthermore 27% of infants in group 1 and 3% in group 2 had still diarrhea on Day 5. The stool frequency and weight changes were not statistically different in the two groups. No major side effects were observed except two cases of vomiting and hardened stools. It is concluded that (1) Smectite shortens the course of acute secretory diarrhea in Thai infants; (2) smectite may reduce the occurrence of prolonged diarrhea; furthermore (3) in our study dioctahedral smectite was found to be safe in children aged 1 to 24 months.