NEW RECOMMENDATIONS FOR CLINICAL MANAGEMENT OF DIARRHEA: WHO 2006
Improved ORS formulations
Efficacy of ORS solution for treating children with acute non-cholera diarrhea is improved by reducing its sodium concentration to 75 mEq/L, its glucose concentration to 75 mmol/L and its total osmolarity to 245 mosm/L. The need for unscheduled supplemental IV therapy in children given this solution was reduced by 33%. The 245 mosm/L solution also appeared to be as safe and at least as effective as standard ORS for use in children with diarrhea.
Thus WHO and UNICEF now recommend that countries use the following formulation in place of previously recommended ORS solution with total osmolarity of 311 mosm/L.
WHO and UNICEF acceptable ORS formulations
Implementation of low osmolarity ORS
Zinc supplement in treatment of acute diarrhea
The use of zinc is thought to hasten epithelial recovery during diarrhea and restore intestinal structure or function. WHO convened a meeting of experts in 2001 and concluded that zinc supplementation given at a dose of 10-20 mg per day for 10-14 days is efficacious in significantly reducing severity of diarrhea and duration of the episode.
Implementation of zinc
Antidiarrheal drugs that should never be used for treatment of acute diarrhea
Adsorbents - kaolin, attapulgite, smectite, activated charcoal, cholestyramine.
Antimotility drugs - loperamide, diphenoxylate with atropine, opium, paregoric, codeine, Bismuth subsalicylate.
Implementing the New Recommendations on the Clinical Management of Diarrhoea. Guidelines for Policy Makers and Programme Managers. World Health Organization. Geneva, 2006.
|Previous Print Article||Next Print Article|