[Treatment of acute diarrhea: prescription patterns by private practice pediatricians].
Acute gastroenteritis remains a frequent illness in infants and children with still important morbidity and mortality rates. Oral rehydratation solutions (ORS) and early refeeding are the main recommendations. Indication of drugs remains limited.


OBJECTIVE
To evaluate the management of acute diarrhea by private practice pediatricians of France.


METHODS
A questionnaire concerning ORS, dietary formula, antidiarrheal diet, antibiotherapy, antidiarrheal drugs was sent to all 2907 private pediatricians of France.


RESULTS
Six hundred twenty-nine questionnaires were analyzed (22%). Three hundred and ninety-seven pediatricians (63%) prescribed systematically an ORS, 294 (47%) changed formula, 412 (66%) prescribed a regimen. Antibiotic was prescribed after coproculture (81%), when glairy and bloody diarrhea (65%), associated infectious disease (63%), toxi-infectious syndrome (42%) or immunodeficiency were present (28%). Most pediatricians (97%) prescribed at least one drug: diosmectite (84%), Lactobacillus acidophilus (63%), Saccharomyces boulardii (62%), racecadotril (62%), loperamide (28%), attapulgite de Mormoiron (26%), nifuroxazide (20%). Drugs were prescribed more often for their effectiveness than for comfort.


CONCLUSIONS
This study demonstrates the discrepancies that remain between recommendations and practical care in the treatment of acute diarrhea in children. Private French pediatricians often prescribe drugs.
Unité de gastroentérologie, hépatologie et nutrition, clinique de pédiatrie, hôpital Jeanne-de-Flandre, faculté de médecine, 1, place de Verdun, 59037 Lille cedex, France.
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D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003968:Diarrhea, Infantile / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D004502:Education, Medical, Continuing / Q000592:standards; D005440:Fluid Therapy / Q000706:statistics & numerical data; D005602:France; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007225:Infant Food; D008485:Medical Audit; D020380:Needs Assessment; D010290:Parents / Q000193:education; D010372:Pediatrics / Q000193:education / Q000592:standards / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011331:Private Practice / Q000592:standards / Q000706:statistics & numerical data*; D015532:Rehydration Solutions / Q000627:therapeutic use; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D015532:Rehydration Solutions