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Acute infectious diarrhea in children
Sibylle Koletzko1, Stephanie Osterrieder
1Abteilung für Pädiatrische Gastroenterologie und Hepatologie, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München. Sibylle.Koletzko@med.uni-muenchen.de
Deutsches Arzteblatt International
|September 10, 2009
Summary
Acute infectious enteritis in children is common, but treatment guidelines are often not followed. Oral rehydration solution (ORS) effectively treats dehydration in over 90% of cases, avoiding IV fluids.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Acute infectious enteritis is a prevalent childhood illness globally, particularly affecting children under three.
- In Germany, one in six children under five consults a physician for infectious diarrhea annually.
- Rotavirus infection leads to hospitalization in 10% of affected children.
Purpose of the Study:
- To review current national and international guidelines for treating acute infectious diarrheal disease in children.
- To emphasize the importance of adhering to evidence-based treatment recommendations.
- To highlight effective rehydration strategies for pediatric gastroenteritis.
Main Methods:
- A selective literature search was conducted.
- The search focused on national and international guidelines for managing infectious diarrhea.
- Evidence-based recommendations were synthesized.
Main Results:
- The primary therapeutic objective is to restore fluid and electrolyte balance disrupted by diarrhea and vomiting.
- Hypotonic oral rehydration solution (ORS) is recommended for impending or existing mild-to-moderate dehydration.
- Frequent, small oral administrations of ORS over 3-4 hours achieve success in over 90% of cases.
Conclusions:
- Oral rehydration with ORS is a highly effective treatment for pediatric diarrhea and vomiting.
- Regular feeding can resume immediately after successful oral rehydration.
- Intravenous fluid administration should be avoided in children who can be rehydrated orally or via nasogastric tube; laboratory testing is typically unnecessary.
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