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Comparison of an oral rice-based electrolyte solution and a glucose-based electrolyte solution in hospitalized
E Guiraldes1, X Triviño, G Figueroa
1Pontificia Universidad Católica de Chile, Santiago.
Insights
A rice-based oral rehydration solution showed similar efficacy to the standard glucose-based solution for treating acute dehydrating diarrhea in infants. Both treatments achieved comparable rehydration success rates and diarrhea duration.
Area of Science:
- Pediatrics
- Gastroenterology
- Infectious Diseases
Background:
- Acute dehydrating diarrhea is a major cause of infant mortality globally.
- Oral rehydration solutions (ORS) are crucial for managing dehydration.
- Alternative ORS formulations, like rice-based solutions, are explored for improved efficacy.
Purpose of the Study:
- To compare the efficacy of a rice-based ORS versus a standard glucose-based ORS in hospitalized infants with acute dehydrating diarrhea.
- To evaluate key outcomes including stool output and diarrhea duration.
Main Methods:
- A randomized trial involving 100 hospitalized infants (3-18 months) with acute dehydrating diarrhea.
- Comparison of a rice-based (50 g/L) ORS with the standard glucose-based WHO/UNICEF solution.
- Accurate measurement of fluid intake and losses using metabolic beds.
Main Results:
- 89% overall successful oral rehydration; failure rates were similar between groups.
- No significant difference in stool output (24h or total) or diarrhea duration (rice: 3.8 days, glucose: 3.9 days).
- Secondary outcomes (fluid intake, urine output, weight change, electrolytes) were also comparable.
Conclusions:
- Rice-based ORS is as efficacious as glucose-based ORS for treating acute dehydrating diarrhea in infants not associated with cholera.
- Neither solution demonstrated superior outcomes in this study population.
- Rehydration failure was associated with specific E. coli serotypes, not the ORS type.
Abstract:
This randomized trial compared the efficacy of a rice-based (50 g/L) oral rehydration solution with the standard glucose-based WHO/UNICEF solution in the treatment of 100 hospitalized infants, ages 3-18 months, with acute dehydrating diarrhea. The main outcomes examined were stool output and duration of diarrhea. Patients were placed on a "metabolic" bed so that intake and losses could be measured accurately throughout the study. Overall, 89% of patients were successfully rehydrated orally; the rehydration failure rate was similar in the two groups and it was significantly associated with infection by specific E. coli serotypes. Stool output in the first 24 h was 11% lower in the rice group (112 versus 126 ml/kg), but this difference was not significant. Neither stool output in the second 24 h nor total stool output were different between groups. The median duration of diarrhea was 3.8 days in the rice group and 3.9 days in the glucose group (p = NS). Other (secondary) outcomes, such as fluid intake, urine output, emesis losses, weight change, and electrolyte balance were also similar between the two groups. Some evidence of carbohydrate malabsorption was detected in 61% of the rice group versus 45% of the glucose group (p = NS) and was not associated with any particular treatment outcome. These results show that a rice-based oral rehydration solution is as efficacious as, but not better than the standard glucose-based solution in the treatment of infants with acute dehydrating diarrhea not associated with cholera.