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Oral therapy in children with cholera: a comparison of sucrose and glucose electrolyte solutions
Insights
Sucrose electrolyte oral solution is an effective alternative to glucose for treating severe diarrhea in children. Both solutions showed similar success rates, highlighting the importance of fluid therapy regardless of sugar type.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Severe diarrhea, particularly cholera, poses a significant risk to children under five.
- Oral rehydration therapy (ORT) is crucial for managing dehydration.
- The type of carbohydrate (sugar) in ORT solutions can impact efficacy.
Purpose of the Study:
- To compare the efficacy of sucrose-electrolyte oral solution versus glucose-electrolyte oral solution in children with severe diarrhea.
- To determine if sucrose is a viable alternative to glucose in ORT for cholera-like diarrhea.
Main Methods:
- A double-blind, randomized controlled trial was conducted.
- 111 children under 5 years with severe diarrhea were enrolled (102 with confirmed cholera).
- Patients received either sucrose-electrolyte or glucose-electrolyte oral solution.
Main Results:
- Success rates (avoidance of intravenous therapy) were similar: 73% for sucrose and 77% for glucose.
- No significant difference in purging rates was observed between the groups.
- Sucrose malabsorption was a rare cause of treatment failure in one patient.
Conclusions:
- Sucrose-electrolyte oral solution is an effective alternative to glucose-electrolyte oral solution for treating severe dehydrating diarrhea in children.
- The purging rate was the primary determinant of successful oral fluid therapy.
- ORT should be used alongside intravenous therapy for severe dehydration.
Abstract:
We performed a double-blind trial comparing sucrose electrolyte oral solution with glucose electrolyte oral solution in children less than 5 years of age with severe cholera-like diarrhea. Of 111 patients studied (102 with bacteriologically confirmed cholera), 55 received sucrose solution and 56 received glucose solution. The success rates, as defined by the absence of the need to give unscheduled intravenous therapy, were similar in the two groups (73% and 77% in the sucrose and glucose groups, respectively). There was no difference in purging rates between the two groups. The primary determinant of success for oral fluid regardless of the sugar was the purging rate. Sucrose malabsorption was responsible for oral therapy failure in one child. This study demonstrates that sucrose is an effective alternative to glucose in the oral therapy solution, but either must be used in conjunction with intravenous solution when treating severe dehydrating diarrhea.