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Acute Infectious Gastroenteritis in Infancy and Childhood

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eMediNexus    03 April 2021

Acute infectious gastroenteritis is the second most common non-traumatic cause of emergency hospitalization in children, 1-5 years of age, accounting for approximately 9% of the cases. The most common pathogens are viruses – 47% rotavirus; 29% norovirus; and 14% adenovirus.

The goal of a recent study published in Deutsches Arzteblatt International was to enable – judgement of patients’ degree of dehydration based on their weight loss and other clinical signs; estimation of nutrition to be administered to children with acute infectious gastroenteritis; and treatment of clinical dehydration according to degree of severity.

This review entailed evaluation of publications retrieved by a selective search in PubMed, with consideration of relevant guidelines. 

The results indicated that the degree of dehydration can be guaged from weight loss and other clinical findings. In 17 randomized controlled trials that included 1 811 children with mild or moderate dehydration, oral rehydration solution was as effective as intravenous rehydration with respect to weight gain, duration of diarrhea and fluid administration, along with shorter hospital stays. However, ORT failure was recorded in 4% patients. In children who had vomiting or who refuse oral rehydration solution, continuous nasogastric application was found to be equivalent in efficacy as intravenous rehydration, and was the treatment of first choice.

It was concluded that in children with mild or moderate dehydration, there exists good evidence supporting ambulatory oral rehydration.

Source: Deutsches Arzteblatt International. 2020 Sep 11;117(37):615-624. doi: 10.3238/arztebl.2020.0615.

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