A comparative analysis of response to ORS (oral rehydration solution) vs. ORS + gelatin tannate in two cohorts of pediatric patients with acute diarrhea

Abstract

Aim: the study aims to observe the response to treatment with ORS only or ORS + gelatin tannate in two cohorts of pediatric patients with acute diarrhea, with the primary efficacy endpoint being the number of stools at 12 hours from baseline.Methods: children aged 3 months to 12 years were included in the study. Only children with acute diarrhea, more than 3 liquid stools, and duration inferior to 72 h were included. Number of stools was recorded as absolute number, categorized as ≤ 3 and ≥ 4 stools over 12 hours, and as a stool decrease index (SDI). Other clinical variables were recorded, including weight, fever, vomiting, stool characteristics, and signs of peritonitis/sepsis.Results: baseline characteristics for the two populations included a mean age of 2.3 years in the ORS group and 2.6 years in the ORS + gelatin tannate group. Children younger than 2 years represented 59.8 and 54.3% in the ORS and ORS + gelatin tannate groups, respectively. Clinical variables such as vomiting, dehydration, weigth, and stool decrease index were used to compare the two groups. We found a statistical significant difference between the two groups (p < 0.0001) --SDI for the ORS group was -0.1894; for the ORS + gelatin tannate group was -0.6023.Conclusions: we observed a significant decrease in the number of stools and an improvement in the consistency of stools in the ORS + gelatin tannate group. Other clinical variables such as vomiting, dehydration, weight, bloody stools, and peritonitis/sepsis signs showed no statistical differences between the two groups, but did show a general trend toward improvement. The Stool Decrease Index (SDI) showed a 18% decrease in the number of stools for the ORS group and 60% for the ORS + gelatin tannate group. The use of ORS + gelatin tannate was associated with a greater decrease in SDI. Gelatin tannate decreased the number of stools at twelve hours in children.

Xyloglucan for the treatment of acute diarrhea: results of a randomized, controlled, open-label, parallel group, multicentre, national clinical trial

“…Reduction of abdominal pain is also important for the whole management of diarrhea, in which, the administration of anti-inflammatory drugs as NSAIDs can alter the integrity of mucus layer [1, 2, 4, 5]. …”

“…Other causes include side effects of drugs (especially antibiotics), infections not associated with the gastrointestinal tract, food poisoning, and allergy [2, 4, 5]. …”

“…Despite the introduction of oral rehydration therapies, annual global mortality rate is still high, with an estimate of 2.5 million people (with higher rates in children [5–7]. After perinatal death (23 %) and acute respiratory infection (18 %), acute diarrhea represents the third cause of death (15 %) in children under the age of 5 living in developing countries [5–7].…”

“…After perinatal death (23 %) and acute respiratory infection (18 %), acute diarrhea represents the third cause of death (15 %) in children under the age of 5 living in developing countries [5–7]. …”

“…Antibiotics, motility inhibitors such as loperamide, or substances that decrease water and electrolyte secretion such as racecadotril can be useful, although with some adverse events (such as the bacterial overgrowth induced by motility-reducing drugs), only in very specific situations [5]. …”