Comparative efficacy of rice-based and glucose-based oral rehydration salts plus early reintroduction of food

Fayad, Ibrahim; Hashem, Mohamed; Refat, Mamdouh; Bakır, Melike; Fontaine, Olivier; Duggan, Christopher; Santosham, Mathuram

doi:10.1016/0140-6736(93)91540-3

Cited by 49 publications

(25 citation statements)

References 18 publications

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“…Continued breast-feeding or early reintroduction of normal feeding is supported by several studies. [182][183][184] Children should continue to receive their normal diet; lactose-free milk has not been shown to be associated with improved outcomes except in malnourished or severely dehydrated children. 185 Severe dehydration should be treated with intravenous fluids where available over 3 to 6 hours.…”

Section: Infant Diarrhea In Developing Countriesmentioning

confidence: 97%

Infectious Diarrhea in Developed and Developing Countries

Cheng¹,

McDonald²,

Thielman³

2005

Journal of Clinical Gastroenterology

108

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Diarrhea from gastrointestinal infection remains a common problem. In industrialized countries, management is aimed at reducing morbidity and defining groups that may benefit from further investigation. Most infectious diarrhea is self-limiting and only requires supportive management. Viral agents are increasingly recognized as causative agents of epidemic and sporadic diarrhea. In developing countries, diarrhea is a major cause of mortality in children. Oral rehydration therapy, guided by a clinical assessment of the degree of dehydration, is cheap, simple, and effective and remains the mainstay of management of infant diarrhea. Controversies focus on the optimal formulation of oral rehydration solution. A vaccine against rotavirus has the potential to save millions of lives worldwide.

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Section: Infant Diarrhea In Developing Countriesmentioning

confidence: 97%

Infectious Diarrhea in Developed and Developing Countries

Cheng¹,

McDonald²,

Thielman³

2005

Journal of Clinical Gastroenterology

108

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“…Recent evidence has shown, however, that when substantial early feeding of a cereal based diet occurs, glucose ORS can be even more effective than cereal based ORT. 23 The overall rate of successful treatment was comparable (70% v 72%) in the two treatment groups but was lower than the rates reported in similar previous studies.7 9 24 25 Several factors may explain the differences. The mean age of the patients in earlier studies of cereal based ORT were all at least twice that of the patients in this study.7 9 24 25 In the study with the youngest patients (mean age 7 months), El Mougi et al reported a success rate of 83%,9 which more closely approximates the rate in our study.…”

Section: Resultsmentioning

confidence: 76%

“…(Arch Dis Child 1994; 71: [19][20][21][22][23] The worldwide use of oral rehydration therapy (ORT), primarily the glucose based oral rehydration salts (ORS) solution advocated by the World Health Organisation (WHO) and Unicef has greatly improved the outlook for millions of patients with acute diarrhoeal disease.' These solutions are used in only about 20% of diarrhoeal episodes, however.'…”

Section: J D Snydermentioning

confidence: 99%

Is rice based oral rehydration therapy effective in young infants?

Islam

Ahmed

Yameen

et al. 1994

Archives of Disease in Childhood

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“…Other study centres were in Egypt (three trials) (el-Mougi 1988; Fayad 1993; el-Mougi 1996); Chile (two trials) (Guiraldes 1995a; Guiraldes 1995b); Mexico (two trials) (Maulen-Radovan 1994; Maulen-Radovan 2004); and one trial each was done in Australia (Wall 1997), Colombia (Bernal 2005), Madagascar (Razafindrakoto 1993), Malaysia (Iyngkaran 1998), Pakistan (Islam 1994), the Philippines (Santos Ocampo 1993), Romania (Nanulescu 1999), Sudan (Mustafa 1995), and Thailand (Intarakhao 2010). All but two trials were conducted in hospital settings.…”

Section: Resultsmentioning

confidence: 99%

Polymer-based oral rehydration solution for treating acute watery diarrhoea

Gregorio

Gonzales

Dans

et al. 2016

Cochrane Database of Systematic Reviews

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BackgroundAcute diarrhoea is one of the main causes of morbidity and mortality among children in low-income countries. Glucose-based oral rehydration solution (ORS) helps replace fluid and prevent further dehydration from acute diarrhoea. Since 2004, the World Health Organization (WHO) has recommended the osmolarity of less than 270 mOsm/L (ORS ≤ 270) versus greater than 310 mOsm/L formulation (ORS ≥ 310). Polymer-based ORS (for example, prepared using rice or wheat) slowly releases glucose and may be superior to glucose-based ORS.ObjectivesTo compare polymer-based oral rehydration solution (polymer-based ORS) with glucose-based oral rehydration solution (glucose-based ORS) for treating acute watery diarrhoea.Search methodsWe searched the following sources up to 5 September 2016: the Cochrane Infectious Diseases Group (CIDG) Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), MEDLINE (1966 to 5 September 2016), EMBASE (1974 to 5 September 2016), LILACS (1982 to 5 September 2016), and mRCT (2007 to 5 September 2016). We also contacted researchers, organizations, and pharmaceutical companies, and searched reference lists.Selection criteriaWe included randomized controlled trials (RCTs) of people with acute watery diarrhoea (cholera and non-cholera associated) that compared polymer-based and glucose-based ORS (with identical electrolyte contents).Data collection and analysisTwo review authors independently assessed the search results and risk of bias, and extracted data. In multiple-treatment arms with two or more treatment groups, we combined outcomes as appropriate and compared collectively with the control group.Main resultsThirty-five trials that included 4284 participants met the inclusion criteria: 28 trials exclusively included children, five included adults, and two included both adults and children.Polymer-based ORS versus glucose-based ORS (osmolarity ≤ 270)Eight trials (752 participants) evaluated this comparison, and seven trials used rice as a polymer source. Polymer-based ORS may decrease mean stool output in the first 24 hours by 24 mL/kg (mean difference (MD) −24.60 mL/kg, 95% CI −40.69 to −8.51; one trial, 99 participants, low quality evidence). The average duration of diarrhoea may be reduced by eight hours (MD −8.24 hours, 95% CI −13.17 to −3.30; I² statistic = 86%, five trials, 364 participants, low quality evidence) with polymer ORS but results are heterogeneous. Limited trials showed no observed difference in the risk of unscheduled use of intravenous fluid (RR 0.66, 95% CI 0.43 to 1.02; I² statistic = 30%; four trials, 376 participants, very low quality evidence), vomiting (very low quality evidence), and hyponatraemia (very low quality evidence).Polymer-based ORS versus glucose-based ORS (osmolarity ≥ 310)Twenty-seven trials (3532 participants) evaluated this comparison using a variety of polymers. On average, polymer ORS may reduce the total stool output in the first 24 hours by around 65 mL/kg (MD −65.47 mL/kg, 95% CI −83....

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Comparative efficacy of rice-based and glucose-based oral rehydration salts plus early reintroduction of food

Cited by 49 publications

References 18 publications

Infectious Diarrhea in Developed and Developing Countries

Infectious Diarrhea in Developed and Developing Countries

Is rice based oral rehydration therapy effective in young infants?

Polymer-based oral rehydration solution for treating acute watery diarrhoea

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