MANAGEMENT OF ACUTE GASTROENTERITIS IN CHILDREN: WHAT IS NEW?
https://doi.org/10.15690/vsp.v12i4.738
Abstract
High prevalence of acute enteric infections in children, the majority of which affects infants, determines the necessity of development of modern recommendation on diagnostics and treatment of such conditions. The authors show data on etiology of enteric infections and results of various Russian and international research on efficacy of treatment of acute gastroenteritis, including information about sorbents, probiotics, antiemetic agents and antibacterial drugs usage. Recommendations on treatment of acute gastroenteritis are based on the modern protocol of the European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists (ESPGHAN), which was published in 2008. According to these recommendations, oral rehydration is one of the main components of treatment, decreasing children’s mortality rates. However due to the absence of the effect of this measure on the intestinal peristalsis, duration of the diarrhea and concomitant symptoms (abdominal pain and distension), additional therapy is necessary. In Russia combinations of enterosorbents and probiotics are used in order to relieve such conditions.
About the Authors
I. N. Zakharova
Russian Medical Academy of Postgraduate Education, Moscow
Russian Federation
Russian Federation
Zakharova Irina Nikolaevna, PhD, professor, Head of the Pediatrics Department of the Faculty of Pediatrics of Russian Medical Academy of Post-Graduate Education, Chief Pediatrician of the Central Federal Region of Russian Federation, Honoured Doctor of Russian Federation
A. V. Esipov
N.N. Burdenko Central Military Clinical Hospital, Moscow
Russian Federation
Russian Federation
E. A. Doroshina
N.N. Burdenko Central Military Clinical Hospital, Moscow
Russian Federation
Russian Federation
R. G. Loverdo
N.I. Semashko Rostov Municipal Hospital
Russian Federation
Russian Federation
Yu. A. Dmitrieva
Russian Medical Academy of Postgraduate Education, Moscow
Russian Federation
Russian Federation
References
1. Gorelov A. V., Milyutina L. N., Usenko D. V. Klinicheskie rekomendatsii po diagnostike i lecheniyu OKI u detei [Clinical Recommendations on Diagnosis and Treatment of Acute Enteric Infections in Children]. Moscow, 2005. 106 p.
2. Tolia V. Acute infections diarrhea in children. Curr. Treat Options Infect. Dis. 2002; 4: 183–194.
3. Vorotontsyva N. V. Pediatriya — Pediatrics. 1995; 4: 76–78.
4. Pokrovskii V. I., Onishchenko G. G., Cherkasskii B. A. Zhurnal mikrobiologii — Journal of Microbiology. 2002; 3: 16–23.
5. Vasil'ev B.Ya., Sirokin A. K., Sukhinin V. P. Primenenie PEM v diagnostike nebakterial'nykh gastroenteritov. Ostrye kishechnye infektsii: Sb. nauchn. trudov [Application of TEM (transmission electronic microscopy) in Diagnosis of Abacterial Gastroenteritis. Acute Enteric Infections: Collection of Scientific Studies]. Leningrad, 1986. pp. 40–42.
6. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases Evidence-based Guidelines for the Management of Acute Gastroenteritis in Children in Europe. JPGN. 2008; 46: 81–122.
7. The treatment of diarrhea — a manual for physicians and other senior health workers. Geneva, Switzerland: World Health Organization. 2005. Fourth revision. http://whqlibdoc.who. int/hq/2003/WHO_FCH_CAH_03.7.pdf.
8. Dizenteriya i drugie ostrye kishechnye infektsii. Ukazaniya po diagnostike, lecheniyu i profilaktike v Vooruzhennykh Silakh RF [Dysentery and Other Acute Enteric Infections. Guidance for Diagnosis, Treatment and Preventive Measures in the Armed Forces of the Russian Federation]. Moscow, 2000. 132 p.
9. Fonseca B. K., Holdgate A., Craig J. C. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a meta-analysis of randomized controlled trials. Arch. Pediatr. Adolesc. Med. 2004; 158: 483–490.
10. Sheptulin A. A. Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii — The Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2002; 1: 18–22.
11. Alhashimi D., Alhashimi H., Fedorowicz Z. Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents. Cochr. Database Syst. Rev. 2006; CD005506.
12. Szajewska H., Gieruszczak-Bialek D., Dylag M. Meta-analysis: ondansetron for vomiting in acute gastroenteritis in children. Aliment. Pharmacol. Ther. 2007; 25: 393–400.
13. Li S. T., Grossman D. C., Cummings P. Loperamide therapy for acute diarrhea in children: systematic review and meta-analysis. PLoS Med. 2007; 4: 98.
14. Szajewska H., Dziechciarz P., Mrukowicz J. Meta-analysis: Smectite in the treatment of acute infectious diarrhea in children. Aliment. Pharmacol. Ther. 2006; 23 (2): 217–227.
15. Dupont C., Foo J. L., Garnier P., Moore N., Mathiex-Fortunet H., Salazar-Lindo E. Oral diosmectite reduces stool output and diarrhea duration in children with acute watery diarrhea. Clin. Gastroenterol. Hepatol. 2009; 7 (4): 456–462.
16. Doroshina E. A. Kliniko-epidemiologicheskie osobennosti i voprosy terapii norovirusnoi infektsii u detei. Avtoref. diss … kand. med. nauk [Clinical and Epidemiological Specific Features and Current Therapy of Norovirus Infection in Children. Author’s abstract]. Moscow, 2010. 24 p.
17. Kozina G. A. Kliniko-epidemiologicheskie osobennosti i voprosy terapii ostrykh kishechnykh infektsii adenovirusnoi etiologii u detei. Avtoref. diss … kand. med. nauk [Clinical and Epidemiological Specific Features and Current Therapy of Acute Enteric Infections of Adenovirus Etiology in Children. Author’s abstract]. Moscow, 2010. 24 p.
18. Haltalin K. C., Nelson J. D., Ring R., 3rd et al. Double-blind treatment study of shigellosis comparing ampicillin, sulfadiazine, and placebo. J. Pediatr. 1967; 70: 970–981.
19. Ashkenazi S., Amir J., Waisman Y. et al. A randomized, doubleblind study comparing cefixime and trimethoprim-sulfame thoxazole in the treatment of childhood shigellosis. J. Pediatr. 1993; 123: 817–821.
20. Martin J. M., Pitetti R., Maffei F. et al. Treatment of shigellosis with cefixime: two days vs. five days. Pediatr. Infect. Dis. J. 2000; 19: 522–526.
21. Basualdo W., Arbo A. Randomized comparison of azithromycin versus cefixime for treatment of shigellosis in children. Pediatr. Infect. Dis. J. 2003; 22: 374–377.
22. Miron D., Torem M., Merom R. et al. Azithromycin as an alternative to nalidixic acid in the therapy of childhood shigellosis. Pediatr. Infect. Dis. J. 2004; 23: 367–368.
23. Leibovitz E., Janco J., Piglansky L. et al. Oral ciprofloxacin vs. intramuscular ceftriaxone as empiric treatment of acute invasive diarrhea in children. Pediatr. Infect. Dis. J. 2000; 19: 1060–1067.
24. Ternhag A., Asikainen T., Giesecke J. et al. A meta-analysis on the effects of antibiotic treatment on duration of symptoms caused by infection with Campylobacter species. Clin. Infect. Dis. 2007; 44: 696–700.
25. Salazar-Lindo E., Sack R. B., Chea-Woo E. et al. Early treatment with erythromycin of Campylobacter jejuni-associated dysentery in children. J. Pediatr. 1986; 109: 355–360.
26. Ashkenazi S., Danziger Y., Varsano Y. et al. Treatment of Campylobacter gastroenteritis. Arch. Dis. Child. 1987; 62: 84–85. 27. Sirinavin S., Garner P. Antibiotics for treating salmonella gut infections. Cochr. Database Syst. Rev. 2000; CD001167.
Review
For citations:
Zakharova I.N., Esipov A.V., Doroshina E.A., Loverdo R.G., Dmitrieva Yu.A. MANAGEMENT OF ACUTE GASTROENTERITIS IN CHILDREN: WHAT IS NEW? Current Pediatrics. 2013;12(4):120-125. (In Russ.) https://doi.org/10.15690/vsp.v12i4.738
Views:
916
Email this article 
