Management of Acute Gastroenteritis in Children in Israel

Shamir, Raanan; Zahavi, I; Abramowich, Tova; Poraz, Irit; Tal, Dalia; Pollak, Shlomo; Dinari, Gabriel

doi:10.1542/peds.101.5.892

Cited by 18 publications

(8 citation statements)

References 7 publications

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“…The French survey of pediatricians in 2004 showed that 63% allowed rehydration using ORS as compared to 16% of pediatricians in a multi-center European study conducted in 2000, 87% of Israeli pediatricians in 1998, and 30% of US pediatricians in 1991[6–9]. In our survey, 92% of Lebanese pediatricians recommended ORS at the beginning of treatment for rehydration.…”

Section: Discussionmentioning

confidence: 64%

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Management of acute gastroenteritis in healthy children in Lebanon - A national survey

Alameddine

Mourad

Rifai

2010

NAJMS

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Background:Acute gastroenteritis remains a common condition among infants and children throughout the world. In 1996, The American Academy of Pediatrics (AAP) revised its recommendations for the treatment of infants and children with acute gastroenteritis.Aim:The purpose of this survey was to determine how closely current treatment among Lebanese pediatricians compares with the AAP recommendations and to determine the impact of such management on the healthcare system.Patients and Methods:The outline of the study was based on a telephone questionnaire that addressed the management of healthy infants and children below five years of age with acute gastroenteritis complicated by mild to moderate dehydration. In addition, the costs of medical treatment and requested laboratory studies were calculated.Results:A total of 238 pediatricians completed the questionnaire. Most pediatricians prescribed Oral Rehydration Solutions (ORS) for rehydration (92.4%), advised breastfeeding during acute gastroenteritis (81.5%), and avoided parenteral rehydration for mild to moderate dehydration (89.1%). In addition to ORS, oral fluids such as soda, juices, and rice water were allowed for rehydration by 43.7% of pediatricians. Thirty-one percent of pediatricians delayed re-feeding for more than 6 hours after initiation of rehydration. Only 32.8% of pediatricians kept their patients on regular full-strength formulas, and only 21.8% permitted full-calorie meals for their patients. 75.4% of pediatricians did not order any laboratory studies in cases of mild dehydration and 50.4% did not order any laboratory studies for moderate dehydration. Stool analysis and culture were ordered by almost half of the pediatricians surveyed. Seventy-seven percent prescribed anti-emetics, 61% prescribed probiotics, 26.3% prescribed antibiotics systematically and local antiseptic agents, 16.9% prescribed zinc supplements, and 11% percent prescribed antidiarrheal agents.Conclusion:Pediatricians in Lebanon are aware of the importance of ORS and the positive role of breastfeeding in acute gastroenteritis. However, they do not follow optimal recommendations from the AAP concerning nutrition, laboratory examinations and drug prescriptions. Consequently, this poses significant financial losses and economic burden.

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Section: Discussionmentioning

confidence: 64%

“…Pediatricians who graduated in the last two decades and those working in teaching hospitals and/or in urban areas were more likely to adhere to the AAP guidelines than the other groups. A similar study done in Israel in 1998 showed that 60% of pediatricians followed these guidelines[6]. …”

Section: Discussionmentioning

confidence: 99%

Management of acute gastroenteritis in healthy children in Lebanon - A national survey

Alameddine

Mourad

Rifai

2010

NAJMS

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“…Numerous guidelines covering various conditions have been developed in recent years in an effort to provide care based on the best available evidence (12,14). However, implementation of such guidelines is incomplete, may face resistance, and usually requires active measures (14,15). Hence, it is interesting to note that the "Practice Parameter" was readily adopted in the studied hospitals, and had a profound impact on the management of neonatal jaundice.…”

Section: Discussionmentioning

confidence: 99%

Effect of publication of the “Practice Parameter for the Management of Hyperbilirubinemia” on treatment of neonatal jaundice

et al. 2001

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The aim of this study was to evaluate the change in the treatment of neonatal jaundice following introduction of the “American Academy of Pediatrics’ Practice Parameter for the management of hyperbilirubinemia in the healthy term newborn'. In a historical control observation cohort study, we examined the rate of phototherapy and exchange transfusions among full‐term (≫37wk gestation) and near‐term (gestational age between 35 and 37 wk and birthweight >2000g) infants in two community hospitals. The study included all consecutive infants born during two 15‐mo study periods immediately before and after the introduction of the new guidelines. Data were prospectively recorded in a computerized database. The rate of phototherapy significantly decreased in the second study period from 7.9% (514/6499) to 2.9% (251/8650) (p < 0.0001) among full‐term infants, and from 20.9% (102/489) to 9.4% (47/502) (p < 0.0001) in near‐term infants. The use of exchange transfusion was significantly higher (p < 0.001) in the first compared to the second period: 0.2% (15/6499) vs 0.03% (3/8650). A significant decrease was found when the data from each hospital were analyzed separately. Conclusion: A significant decrease in the use of phototherapy and exchange transfusion occurred after the publication of the new practice parameters. This trend was observed for both term and preterm newborns, although the new guidelines were not intended for infants born before term.

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“…However, implementation of such guidelines is incomplete, may face resistance, and usually requires active measures (14,15). Hence, it is interesting to note that the "Practice Parameter" was readily adopted in the studied hospitals, and had a profound impact on the management of neonatal jaundice.…”

Section: Discussionmentioning

confidence: 99%

Effect of publication of the “Practice Parameter for the Management of Hyperbilirubinemia” on treatment of neonatal jaundice

et al. 2001

View full text Add to dashboard Cite

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Management of Acute Gastroenteritis in Children in Israel

Cited by 18 publications

References 7 publications

Management of acute gastroenteritis in healthy children in Lebanon - A national survey

Management of acute gastroenteritis in healthy children in Lebanon - A national survey

Effect of publication of the “Practice Parameter for the Management of Hyperbilirubinemia” on treatment of neonatal jaundice

Effect of publication of the “Practice Parameter for the Management of Hyperbilirubinemia” on treatment of neonatal jaundice

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