[MANAGEMENT OF ACUTE DIARRHEA IN INFANTS AND CHILDREN]
Worldwide, diarrhea remains one of the most common causes of children morbidity and mortality in developing countries. Even now, in 1997, in the United States, each year results in near 400 deaths, 200,000 hospitalizations, 1.5 million outpatient visits, and a total of 20 million episodies among children. According to these data, it is easy to understand the real situation in poor countries. It is necessary to consider three specific management issues: (1) rehydration, (2) early refeeding, and (3) treatment of the infectious agent. Intravenous rehydration is the best form of treatment for children with severe dehydration, who are in shock or unable to take oral rehydration. Oral rehydration is simple, practical, inexpensive, effective and safe for children. Appropriate feeding should begin as soon as initial rehydration therapy has been completed, usually within 4 to 6 hours. Antidiarrheal agents are not recommended, because many of these drugs have potentially serious adverse effects in infants and young children. Because stool culture is often expensive and ineffective, a workup of patients with acute diarrhea should include: fecal leukocytes count, fecal hidden blood and fecal lactoferrin. Only a few percentage of patients need to receive antibiotics. The role of nucleotides and probiotics to prevent acute diarrhea is currently investigated.
Alarcón P
Pedro
DR
Alarcón
Jorge
J