[Effect of racecadotril in the management of acute diarrhea in infants and children].
BACKGROUND
The treatment of diarrhoea relies on the maintenance or restoration of hydration with maintenance of an adequate nutritional intake. Racecadotril has been shown to reduce the stools output during acute diarrhoea. The present work was aimed at measuring the number of emergency department visits for acute diarrhoea either the children received racecadotril or not.


METHODS
Racecadotril and rehydration were compared with rehydration alone in children aged three months to three years who had acute diarrhoea and were evaluated in the emergency department (ED). The primary end point was the number of medical exams during the week after starting treatment. Secondary end points were the number of stools during the first 48 hours, the duration of the diarrhoea and the weight on day 7.


RESULTS
One hundred and sixty-six children were alternatively randomized to the treated and the control groups. There was no difference for age, degree of dehydration and length of illness before the first visit between the groups. Whatever type of rehydration (oral or i.v.), the treated group had a significant lower number of stools (p < 0.001) and a faster recovery (p < 10(-9)). The children receiving racecadotril needed less additional ED visits for the same episode (p < 0.05). There was no difference for the weight-gain on day 7.


CONCLUSIONS
This study demonstrates the efficacy of racecadotril as adjuvant therapy to oral and i.v. rehydration in the treatment of acute diarrhoea and a fewer emergency department second visit before recovery.
Département des urgences pédiatriques, AP-HP, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris, France.
B
B
Cojocaru
N
N
Bocquet
S
S
Timsit
C
C
Wille
C
C
Boursiquot
F
F
Marcombes
D
D
Garel
N
N
Sannier
G
G
Chéron
D000208:Acute Disease; D000930:Antidiarrheals / Q000008:administration & dosage / Q000494:pharmacology*; D002675:Child, Preschool; D003681:Dehydration / Q000188:drug therapy / Q000209:etiology; D003967:Diarrhea / Q000188:drug therapy*; D004632:Emergency Medical Services; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D008297:Male; D015244:Thiorphan / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology*; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance
D000930:Antidiarrheals; C049331:racecadotril; D015244:Thiorphan