title: A Comprehensive Comparison of the Efficacy and Tolerability of Racecadotril with Other Treatments of Acute Diarrhea in Adults.
abstract: Racecadotril is a guideline-recommended treatment to alleviate symptoms of acute diarrhea. A systematic review of randomized studies was performed comparing efficacy and safety of treatment with racecadotril to that with placebo or active treatments in adults. In five double-blind studies, racecadotril and placebo had comparable tolerability, but racecadotril was more effective. This was consistent across multiple efficacy parameters including duration of diarrhea, number of diarrheic stools, abdominal pain, and meteorism; it was also consistent across countries in Africa, Asia, and Europe. In six randomized studies in outpatients comparing racecadotril to loperamide, resolution of symptoms occurred with similar speed and efficacy; however, racecadotril treatment was associated with less rebound constipation and less abdominal discomfort. The seventh comparative study performed in geriatric nursing home residents reported a superior efficacy of racecadotril. In direct comparison withSaccharomyces boulardiitreatment, racecadotril exhibited similar tolerability but was more efficacious. One study compared racecadotril to octreotide in patients with acute diarrhea requiring hospitalization, rehydration, and antibiotic treatment; in this cohort, octreotide was more efficacious than racecadotril. In conclusion, in adults with acute diarrhea, racecadotril is more efficacious than placebo orS. boulardii, similarly efficacious as loperamide and, in patients with moderate to severe disease as add-on to antibiotics, less than octreotide. The tolerability of racecadotril is similar to that of placebo orS. boulardiiand better than that of loperamide, particularly with regard to risk of rebound constipation. Taken together, these data demonstrate that racecadotril is a suitable treatment to alleviate symptoms of acute diarrhea in adults.
authors: Medizinische Klinik II, Klinikum Aschaffenburg-Alzenau , Aschaffenburg , Germany.
authors: Wolfgang
authors: W
authors: Fischbach
authors: Medizinische Klinik, Israelitisches Krankenhaus , Hamburg , Germany.
authors: Viola
authors: V
authors: Andresen
authors: Department of Medical Affairs CHC Germany, Boehringer Ingelheim Pharma GmbH & Co KG , Ingelheim , Germany.
authors: Marion
authors: M
authors: Eberlin
authors: Department of Medical Affairs CHC Germany, Boehringer Ingelheim Pharma GmbH & Co KG , Ingelheim , Germany.
authors: Tobias
authors: T
authors: Mueck
authors: Medizinische Klinik, Israelitisches Krankenhaus , Hamburg , Germany.
authors: Peter
authors: P
authors: Layer
keywords: Saccharomyces boulardii; diarrhea; loperamide; octreotide; racecadotril