Adherence to treatment guidelines for acute diarrhoea in children up to 12 years in Ujjain, India - a cross-sectional prescription analysis

Table 1 The Indian Academy Of Paediatrics Recommendations for the treatment of acute diarrhoea in children [6, 7]

	Drug	Recommendations
1.	Low osmolarity ORS	Universal ORS for all ages in all types of diarrhoea.
2.	Zinc supplementation	A uniform dose of 20 mg of elemental zinc should be given during the period of diarrheal and for 7 days after cessation of diarrheal to children older than 3 months.
3.	Pre-biotics, probiotics and Racecadotril	Presently insufficient evidence to recommend in the treatment of acute diarrhoea.
4.	Antiemetics^a	Reserved for children in whom the vomiting is severe, recurrent and interferes with ORS intake.
5.	Antibiotics^b	To be used only for acute bloody diarrhoea (stools with visible blood); recommended in 2004 guidelines only [6]. The dug of choice is Co-trimoxazole if local prevalence of resistance in Shigella is less than 30%; nalidixic acid if resistance exceeds 30%, norfloxacin, ciprofloxacin or a third generation cephalosporin must be used as second and third line drugs.

^aA single dose of domperidone is recommended in children with severe vomiting.
^bAntibiotics are not indicated for children with acute diarrhoea and no visible blood in stools, with pus cells on stool microscopy. IAP does not recommend routine stool examination in children with acute diarrhoea. Entamoeba histolytica and helminths are very rare causes of acute diarrhoea in children thus; metronidazole and antihelminthics have no role. Aminoglycosides like gentamicin and amikacin are ineffective in the management of acute bloody diarrhoea.

ISSN: 1471-2334