Dehydration during acute diarrhea is a significant cause of illness and death in children throughout the world.
Oral rehydration, replacing lost water and electrolytes, is the principal therapy for acute watery diarrhea.
Dr Eduardo Salazar-Lindo and his team in Lima, Peru investigated whether racecadotril, in combination with oral rehydration therapy, would be a more effective treatment than oral rehydration alone for children with acute diarrhea.
"This study provides strong evidence that racedotril is effective treatment for acute watery diarrhoea in boys."
Dr Eduardo Salazar-Lindo
Racecadotril (acetorphan) is an enkephalinase inhibitor. It exerts its antidiarrheal effects by preventing the breakdown of enkephalins in the gastrointestinal tract.
135 boys aged 3 to 35 months with acute water diarrhea took part in the study.
All of the boys were given oral rehydration therapy. 68 boys received racecatodril (1.5 mg/kg of bodyweight every eight hours), while the remaining 67 were given placebo.
In the racecadotril group, the mean stool output over 48 hours was 92 g/kg of bodyweight compared to 170 g/kg for the placebo group, indicating a 46% reduction in stool output for the racecadotril group.
Racecadotril decreased 48-hour stool output by 46%
Mean total stool output was 157 g/kg in the racedotril group, but 331 g/kg in the placebo group.
Diarrhea lasted a mean 28 h in the racedotril group, but 72 and 52 h in the rotavirus +ve and -ve placebo groups, respectively.
After 5 days, 84% of the boys in the racecadotril group had made a full recovery compared with 66% of the boys in the placebo group.
Racecadotril was noted to be particularly effective in boys with rotavirus-associated diarrhea, which is thought to be caused by malabsorption.
Racecadotril was generally well-tolerated. However, hypokalemia persisted in two boys taking the drug and the researchers recommend that serum potassium levels should be monitored in future trials of the drug as a precautionary measure.