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Published on: November 7, 2018
[Clinical pattern of pediatric acute gastroenteritis in the community]
1Pediatra di famiglia, Cattedra di Medicina di Comunità. Università di Catania. gaetano.bottaro@tiscali.it
Insights
This study analyzed 1140 children with acute gastroenteritis (AGE) treated by family pediatricians. Most cases had mild symptoms, with low rates of severe dehydration and hospitalization, suggesting routine outpatient management is effective for community AGE.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Acute gastroenteritis (AGE) is a common childhood illness managed in outpatient settings.
- Family Pediatricians (FP) are primary care providers for pediatric AGE cases.
- Understanding community AGE characteristics is crucial for effective management.
Purpose of the Study:
- To characterize community-based acute gastroenteritis in children.
- To analyze clinical patterns, treatment, and outcomes of pediatric AGE.
- To evaluate the management strategies employed by Family Pediatricians.
Main Methods:
- Retrospective analysis of 1140 children diagnosed with AGE between 2003-2007.
- Data extracted from computerized clinical files (FIMED Infantia).
- Analysis included demographics, clinical presentation, prescribed treatments, and outcomes.
Main Results:
- AGE cases peaked in autumn (October) and were lowest in winter (February).
- Vomiting (34.6%) and fever (27.5%) were common; bloody diarrhea (2.1%) and severe dehydration (0.4%) were rare.
- Antibiotics were prescribed to 22.4% of children, while probiotics (78.3%) and oral rehydration solutions were widely used.
Conclusions:
- Pediatric AGE managed in family pediatrician offices typically presents with mild symptoms.
- Most children experience a regular course with minimal complications, rarely requiring hospitalization.
- Outpatient management by Family Pediatricians is generally effective for community-acquired AGE.
Abstract:
Acute gastroenteritis (AGE) is a typical illness seen in outpatient children, usually treated by Family Pediatricians (FP). To analyze the characteristics of community AGE, we have collected all the case histories of children observed in a FP office, analyzing computerized clinical file (FIMED Infantia), taken from the period 2003-2007. We enrolled 1140 children with AGE were gathered, for an average of 228 cases/year; 578 (51%) males and 562 (49%) females; the month with highest number of cases is October (120 cases, 10.5%), followed by September and April (105 cases in both, 9.2%). The month with the lowest incidence is February (75 cases, 6.6%) followed by August (81 cases, 7.1%); children's mean age is 4.6 +/- 3.4 years with a wide range (10 days divided by 16 years). As regards the clinical pattern, 314 children (27.5%) presented high fever, 395 (34.6%) vomiting and 24 cases (2.1%) bloody diarrhea; mean daily stools is 3.9 +/- 1.1; only 4 children suffered from severe dehydration. 255 children (22.4%) received antibiotic prescription, mainly cotrimoxazole (51%), followed by cephalosporins (39%) and macrolides (10%); 893 children (78.3%) were prescribed probiotics. Oral rehydrating solution was always offered to all children, followed by normal diet and only 4 children (0.4%) need the administration of a lactose free formula. Mean duration of diarrhea was 3.4 +/- 1.7 days, only 10 children (0.9%) suffered from chronic diarrhea and only 2 children (0.2%) were hospitalized due to severe dehydration. In conclusion, the child that refers to the FP office, is often a child with minor symptoms, for whom admission is not required; he/she presents a regular course and slight complications.
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