Efficacy and safety of diosmectite in acute childhood diarrhoea: a meta-analysis

Das, Rashmi Ranjan; Sankar, Jhuma; Ss, Naik

doi:10.1136/archdischild-2014-307632

Cited by 28 publications

(25 citation statements)

References 16 publications

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“…Smectite (a natural adsorbent that binds to endotoxins, exotoxins, bacteria and viral particles) has been reported to decrease the duration of acute diarrhoea by 18–29% in a meta-analysis of mostly open-label trials in children with acute diarrhoea. In addition, smectite has been shown to increase the cure rate at day 5, without any increase in the risk of adverse events and accordingly could be beneficial in some individuals with rotavirus disease 165,166 .…”

Section: Managementmentioning

confidence: 99%

Rotavirus infection

Crawford

Ramani

Tate

et al. 2017

Nat Rev Dis Primers

562

558

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Rotavirus infections are a leading cause of severe, dehydrating gastroenteritis in children <5 years of age. Despite the global introduction of vaccinations for rotavirus over a decade ago, rotavirus infections still result in >200,000 deaths annually, mostly in low-income countries. Rotavirus primarily infects enterocytes and induces diarrhoea through the destruction of absorptive enterocytes (leading to malabsorption), intestinal secretion stimulated by rotavirus non-structural protein 4 and activation of the enteric nervous system. In addition, rotavirus infections can lead to antigenaemia (which is associated with more severe manifestations of acute gastroenteritis) and viraemia, and rotavirus can replicate in systemic sites, although this is limited. Reinfections with rotavirus are common throughout life, although the disease severity is reduced with repeat infections. The immune correlates of protection against rotavirus reinfection and recovery from infection are poorly understood, although rotavirus-specific immunoglobulin A has a role in both aspects. The management of rotavirus infection focuses on the prevention and treatment of dehydration, although the use of antiviral and anti-emetic drugs can be indicated in some cases.

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Section: Managementmentioning

confidence: 99%

Rotavirus infection

Crawford

Ramani

Tate

et al. 2017

Nat Rev Dis Primers

562

558

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“…Nachdem Studien einen Nutzen nachweisen konnten, wird es zunehmend angewendet [174]. Eine aktuelle Metaanalyse berücksichtigt Daten von 2164 Kindern aus 13 Studien hauptsächlich aus Entwicklungsländern wie Malaysia, Peru und Indien [175]. Die Durchfalldauer wird im Mittel um 23,4 Stunden verkürzt und die Wahrscheinlichkeit der Gesundung an Tag 5 ist signifikant höher (OR 4,4).…”

Section: Konsensstärke: 80 % Konsensunclassified

S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

et al. 2019

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Leitlinie der Gesellschaft für pädiatrische Gastroenterologie und Ernährung (GPGE) gemeinsam mit der Deutschen Gesellschaft für Kinder-und Jugendmedizin (DGKJ), dem Berufsverband der Kinder-und Jugendärzte (BVKJ), der Deutschen Gesellschaft für pädiatrische Infektiologie (DGPI), der österreichischen Gesellschaft für Kinder-und Jugendheilkunde (ÖGKJ), der Deutschen Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselstörungen (DGVS), dem Arbeitskreis "Krankenhaus & Praxishygiene" der AWMF und der Deutschen Gesellschaft für Pflegewissenschaft e. V. (DGPW)

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“…It is therefore difficult to assess the effect of bismuth alone, although bismuth salts alone are thought to be unlikely to control Helicobacter pylori infection in humans (Moayyedi et al 2003). Smectite is a clay mineral with presumed barrier effect due to its binding to digestive mucus and which has been used for the treatment of acute diarrhoea in humans, especially in children (Das et al 2015). Sodium alginate is a polysaccharide with a barrier effect, used in human patients for treatment of acid reflux and mild gastric ulceration (Iwakiri et al 2016).…”

Section: Other Gastroprotectantsmentioning

confidence: 99%

“…Smectite is a clay mineral with presumed barrier effect due to its binding to digestive mucus and which has been used for the treatment of acute diarrhoea in humans, especially in children (Das et al . ). Sodium alginate is a polysaccharide with a barrier effect, used in human patients for treatment of acid reflux and mild gastric ulceration (Iwakiri et al .…”

Section: Introductionmentioning

confidence: 97%

Gastroprotectants in small animal veterinary practice – a review of the evidence. Part 1: cyto‐protective drugs

Bazelle

Threlfall

Whitley

2018

J of Small Animal Practice

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Diverse drugs with presumed cytoprotective effect have been used therapeutically in small animal veterinary practice for various gastro-intestinal conditions such as oesophagitis, gastric ulceration, gastritis or chronic gastro-enteropathies. Their efficacy has been doubted in human medicine, raising similar questions in the veterinary field. The aim of this review was to assess the current evidence on the efficacy and safety of these drugs in dogs and cats. Through a systematic review of the literature, we identified 37 articles on the use of misoprostol, sucralfate and other gastroprotectants in dogs and cats. There was evidence to support use of misoprostol in the prevention of aspirin-induced gastroduodenal mucosal injury in dogs, and for use of sucralfate in the prevention of acid-induced oesophagitis in cats. However, the overall quality of evidence supporting the use of these drugs in small animal patients was poor. In contrast, there was evidence of important adverse effects, especially drug interaction and gastro-intestinal signs. We therefore recommend prescribing these drugs with caution until further well-conducted studies reveal a useful gastroprotectant effect.

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Efficacy and safety of diosmectite in acute childhood diarrhoea: a meta-analysis

Abstract: PROSPERO registration: CRD42014013783.

Cited by 28 publications

References 16 publications

Rotavirus infection

Rotavirus infection

S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

Gastroprotectants in small animal veterinary practice – a review of the evidence. Part 1: cyto‐protective drugs

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