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Oral rehydration salts utilization in pediatric diarrhea management among Chinese pediatricians: a national survey
Xinyi Jia1, Xiaoyu Chen1, Xiaorui He1
1Pediatric Endoscopy Center and Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescent's Health and Diseases, Hangzhou, China.
Background:
Oral rehydration salts (ORS) are essential for pediatric diarrhea management. However, not all children with diarrhea receive standardized ORS therapy. This study aimed to assess ORS utilization in the management of pediatric diarrhea among pediatricians in China and to identify factors associated with their ORS prescribing practices.
Methods:
A nationwide cross-sectional survey was conducted among 1,788 pediatricians participating in diarrhea training programs across China between August 2021 and April 2023. Data on demographics, professional characteristics, and ORS practices were collected. Chi-squared tests and logistic regression were used.
Results:
The overall ORS recommendation rate was 85.96%, with significant regional variation (highest: Central South China, 90.22%; lowest: Northeast China, 77.55%). Only 60.57% of pediatricians preferred reduced osmolarity ORS, with the lowest usage in Northwest China (41.73%). Furthermore, 36.81% used ORS only when the child was already dehydrated, 18.12% mistakenly believed that ORS was restricted to oral administration (rising to 25.52% in North China), and 42.51% incorrectly believed that ORS was exclusively for treating diarrhea (reaching 55.65% in North China). Although 98.61% provided guidance to parents, 21.87% incorrectly supported adding fruit juice or milk to ORS. Multiple logistic regression identified higher professional titles and specialization in pediatric gastroenterology as significant predictors of appropriate ORS prescribing practices.
Conclusions:
Deficits exist in the knowledge and practice of ORS in China, especially in specific regions and among certain pediatricians. Future targeted and specific pediatric diarrhea training programs may contribute to more standardized treatment of pediatric diarrhea.
