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The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society of Paediatric Infectious Disease (ESPID) developed evidence-based guidelines for the management of acute gastroenteritis in children in Europe.
Professor Szajewska and colleagues from Poland In 2008 summarized data published subsequently to the ESPGHAN/ESPID guidelines.
MEDLINE and The Cochrane Library were searched in 2012 for randomized controlled trials or their meta-analyses published after 2008.
Efforts to improve the taste and/or efficacy of oral rehydration solution (ORS) continue, and some interventions are promising. While standard nasogastric rehydration is still being used, new evidence confirms that rapid rehydration is also effective. For intravenous rehydration, new evidence is available regarding rapid or ultrarapid and large-volume vs standard-volume rehydration. As the new evidence is not consistent, until more data are available, the administration of 20 mL/kg seems appropriate. The team found evidence showing that ondansetron reduces the risk for vomiting. However, a clearance on safety in children is needed. New evidence has reconfirmed that in Europe, where zinc deficiency is rare, there is no benefit from the use of zinc. The research team identified new data, although mainly from outside of Europe, reconfirming that either smectite or racecadotril is an effective adjunctive therapy to oral rehydration. The team observed a clear effect of using certain probiotics, such as Lactobacillus GG or S. boulardii.
Professor Szajewska's team concludes, "The update of current ESPGHAN/ESPID recommendations is warranted."
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