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Pre-admission management of acute gastroenteritis
E J Elliott1, J A Backhouse, J W Leach
1Department of Paediatrics and Child Health, University of Sydney, New South Wales, Australia.
Insights
Parents often lack knowledge on managing acute gastroenteritis at home, leading to inappropriate medical advice and medication use. Improved education for caregivers and healthcare providers is crucial for effective outpatient management of pediatric gastroenteritis.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Acute gastroenteritis is a common cause of childhood morbidity and hospital admissions.
- Current outpatient management strategies for acute gastroenteritis are often suboptimal.
- Effective home management is essential to reduce hospitalizations.
Purpose of the Study:
- To examine the pre-admission management of children hospitalized with acute gastroenteritis.
- To identify deficiencies in parental knowledge and healthcare provider advice regarding home management.
- To assess the utilization of oral rehydration solutions and inappropriate medication use.
Main Methods:
- A study involving 164 children admitted with acute gastroenteritis.
- Data collected through parental questionnaires and review of medical records.
- Analysis of pre-admission advice on fluid therapy and medication prescriptions.
Main Results:
- Parents demonstrated poor understanding of appropriate home care for gastroenteritis.
- Over 70% sought professional advice, yet oral rehydration solution (ORS) was recommended to only 32% and used by 9%.
- Inappropriate medications, including antibiotics, were prescribed to 22% of children.
Conclusions:
- Oral rehydration therapy is underutilized, while medications are overused in home gastroenteritis management.
- Enhanced education for parents, general practitioners, and hospital doctors is vital for optimizing outpatient care.
- Further research is needed to evaluate the impact of improved outpatient management on hospitalization rates and patient outcomes.
Objective:
Acute gastroenteritis contributes to significant morbidity and need for hospital admission. The current literature suggests outpatient management is often inappropriate. This study examines the pre-admission management of children admitted with acute gastroenteritis to a major children's hospital.
Methodology:
Information was obtained from parental questionnaires and the medical notes for 164 children.
Results:
Parents were poorly informed regarding appropriate home management. Over 70% sought professional advice prior to admission, usually from their general practitioner. Although 58% received advice on fluid therapy, an oral rehydration solution was recommended for only 32%, and only 9% actually used one before admission. Advice regarding fluid requirements was usually inadequate. Inappropriate medications were prescribed for 22% of children, including antibiotics (15.4%), antidiarrhoeals (1.2%) and anti-emetics (5.5%). Hospitalized children were generally well nourished with minimal dehydration and electrolyte disturbance.
Conclusions:
Oral rehydration therapy is utilized rarely and medications are over-utilized in home management of gastroenteritis. Education of parents, general practitioners and hospital doctors is essential to optimize outpatient management. The impact of optimal outpatient management on hospital admission rates and morbidity requires formal assessment.