Oral rehydration formula containing alanine and glucose for treatment of diarrhoea: a controlled trial.
OBJECTIVE
To determine whether adding L-alanine to the glucose based oral rehydration solution recommended by the World Health Organisation would improve its efficacy in treating acute diarrhoea.


METHODS
Randomised double blind controlled trial of oral rehydration solution containing L-alanine and glucose.


METHODS
Inpatient service of a hospital treating diarrhoea.


METHODS
97 Male patients aged 6-59 years admitted to the hospital with acute and severe dehydration due to diarrhoea associated with Vibrio cholerae or enterotoxigenic Escherichia coli. Forty nine received the standard glucose based oral rehydration solution (control group) and 48 this solution with alanine added (study group).


METHODS
All of the patients received rapid intravenous acetate solution for the initial four hours after admission, which fully corrected the signs of dehydration. They were then admitted to the study and randomised. Immediately after the intravenous treatment oral rehydration treatment was started. All of the patients received oral tetracycline for 48 hours, starting 24 hours after start of the study. If signs of dehydration reappeared during oral treatment patients were given rapid intravenous acetate solution until they were fully corrected and then continued to take the assigned oral rehydration solution.


METHODS
Passage of the last watery stool.


RESULTS
The median stool output/kg body weight during the initial 24 hours of oral rehydration treatment and until diarrhoea stopped was reduced in the study group compared with the control group from 309 ml to 196 ml and from 393 ml to 236 ml respectively. Intake of oral rehydration solution and intravenous acetate solution was reduced from 455 ml to 308 ml and from 616 ml to 425 ml respectively. Two patients in the study group compared with 18 patients in the control group required unscheduled rapid intravenous acetate solution to correct signs of dehydration during oral rehydration treatment.


CONCLUSIONS
Oral rehydration solution containing L-alanine was considerably better than standard oral rehydration solution at reducing the severity of symptoms and the need for fluid of male patients with diarrhoea associated with V cholerae and enterotoxigenic E coli.
Patra
F C
FC
International Centre for Diarrhoeal Disease Research, Bangladesh.
Sack
D A
DA
Islam
A
A
Alam
A N
AN
Mazumder
R N
RN
D000293:Adolescent; D000328:Adult; D000409:Alanine / Q000627:therapeutic use*; D001639:Bicarbonates / Q000627:therapeutic use*; D002648:Child; D002771:Cholera / Q000150:complications; D002986:Clinical Trials as Topic; D003967:Diarrhea / Q000209:etiology / Q000628:therapy*; D004311:Double-Blind Method; D004927:Escherichia coli Infections / Q000150:complications; D005440:Fluid Therapy / Q000379:methods*; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011189:Potassium Chloride / Q000627:therapeutic use*; D011897:Random Allocation; D012965:Sodium Chloride / Q000627:therapeutic use*
D001639:Bicarbonates; C044142:World Health Organization oral rehydration solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D005947:Glucose; D000409:Alanine