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[Effects of loperamide on the fecal flora in children in severe diarrheas]
Insights
Loperamide effectively manages severe protracted diarrhea in infants, showing rapid clinical improvement. While some fecal flora changes occurred, no harmful bacterial overgrowth was observed during treatment.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
Background:
- Severe protracted diarrhea poses significant challenges in infant management.
- Loperamide is a potential therapeutic agent for this condition.
Purpose of the Study:
- To evaluate the impact of loperamide on fecal flora in infants with severe protracted diarrhea.
- To assess the clinical efficacy and tolerance of loperamide in this patient group.
Main Methods:
- A study involving 19 infants (1-36 months) with severe protracted diarrhea.
- Comparison between 14 infants receiving loperamide (0.5 mg/kg/d) and 5 controls.
- Analysis of clinical tolerance, stool frequency, transit time, and fecal electrolytes.
- Differential qualitative and quantitative analysis of fecal aerobic and anaerobic bacteria before and after treatment.
Main Results:
- Rapid clinical efficacy (within 24 hours) observed in 9 out of 14 loperamide-treated infants.
- Significant alterations in fecal counts of Streptococcus D and Proteus compared to controls.
- No instances of bacterial overgrowth or increase were detected during loperamide administration.
Conclusions:
- Loperamide demonstrates rapid efficacy in treating severe protracted diarrhea in infants.
- The treatment does not lead to detrimental bacterial overgrowth in the fecal flora.
- Loperamide is a safe and effective option for managing severe protracted diarrhea in pediatric patients.
Abstract:
Loperamide has been recently indicated in the management of infants with severe protracted diarrhea. The purpose of this study was to determine the effect of loperamide on fecal flora in severe protracted diarrheas. 19 children aged 1 to 36 months, with severe protracted diarrhea were studied: 14 received loperamide (0.5 mg/kg/d) and 5 were without loperamide treatment. Criteria analysed were: clinical tolerance (vomiting and abdominal distention); efficacy (number of stools, transit time and Na+/K+ in stools) and effect on fecal flora, with differential qualitative and quantitative analysis method (complete identification and counts of aerobic and strict anaerobic bacteria in fresh fecal samples before and 4 to 8 days after the beginning of loperamide). Parenteral and/or oral alimentation remain constant during the study. Results show a rapid (24 h) efficacy in 9/14. Although important changes in specific fecal flora counts was noticed for streptococcus D and Proteus as compared to five controls, no bacterial overgrowth appeared or was increased during loperamide treatment.