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[Oral rehydration in infants with acute diarrhea: using a new preparation of reduced osmolarity]
I Lentidoro1, E Anastasio, L Pensabene
1Cattedra di Pediatria, Università di R.C., Facoltà di Medicina di Catanzaro, Italia.
Insights
Reduced-osmolarity oral rehydration solutions (ORS) effectively treated acute diarrhea in 36 children, with 33 fully rehydrated within 12 hours. This study supports the use of these ORS in pediatric care.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Public Health
Context:
- Acute diarrhea is a leading cause of childhood illness globally.
- Reduced-osmolarity oral rehydration solutions (ORS) are recommended by the European Society of Pediatric Gastroenterology and Nutrition (ESPGAN).
- Limited evidence exists for reduced-osmolarity ORS efficacy in specific regional settings.
Purpose:
- To evaluate the safety and efficacy of reduced-osmolarity ORS in treating acute diarrhea in children within the local context.
- To assess the rehydration rates and acceptance of the solution in a pediatric cohort.
Summary:
- A study included 38 children (3-24 months) with acute diarrhea; 36 were treated with reduced-osmolarity ORS.
- Pathogens identified included Rotavirus (18), Salmonella (4), EPEC (2), and Cryptosporidium (1).
- 33 of 36 children achieved full rehydration within 12 hours with no adverse effects, demonstrating high acceptance.
Impact:
- Provides crucial local evidence supporting the use of reduced-osmolarity ORS for pediatric acute diarrhea.
- Highlights the safety and effectiveness of ESPGAN-criteria ORS in a real-world clinical setting.
- Informs clinical practice guidelines and public health strategies for managing childhood diarrhea.
Abstract:
Oral rehydration solutions (ORS) are widely employed in the treatment of acute diarrhea in children. Although several studies in the recent literature prove the efficacy and safety of newly formulated, reduced-osmolarity solutions, and a specific working group of the European Society for Pediatric Gastroenterology and Nutrition (ESPGAN) has made similar recommendations, such evidence in our Country is lacking. To this aim, we enrolled 38 children (age from 3 to 24 months, average: 8.2) with acute diarrhea lasting from no more than 5 days (average: 2.5). At observation, dehydration was found to be: absent in 12 (31.6%), mild in 19 (50%), moderate in 5 (13.2%), severe in 2 (5.2%). The last 2 patients were admitted and treated i.v., thus excluded from the study. In the 36 remaining children, a pathogen was identified in 25 (69.4%): Rotavirus in 18, Salmonella in 4, EPEC in 2, Cryptosporidium in 1. Stool Clinitest was positive in 7/31 children, all with Rotavirus infection. All the patients received ad libitum for the first 4-6 hours exclusively a reduced-osmolarity ORS formulated according to the ESPGAN criteria. Afterwards, they were fully re-fed and were also given the same ORS until diarrhea stopped. Most of the children accepted the ORS; those who refused it were either not dehydrated and/or older than 15 months. Thirty-three out of 36 children were fully rehydrated after 12 hours, without any side effects. We conclude that such an ORS is safe and effective in the treatment of children with acute diarrhea in our settings.