USE OF A SINGLE SOLUTION FOR ORAL REHYDRATION AND MAINTENANCE THERAPYOF INFANTS WITH DIARRHEA AND MILD-TO-MODERATE DEHYDRATION

Objective. To compare the efficacy of two commonly used solutions in t he rehydration of infants with mild to moderate dehydration caused by acute diarrhea in the United States. Design and setting. Double-blind, parallel-group, randomized study performed at Children's Hospital Med ical Center. Patients. Sixty infant boys (less than or equal to 2 year s old), with mild (less than or equal to 5%) or moderate (6 to 9%) deh ydration caused by acute diarrhea of less than 1 week's duration were included in the study. Interventions. Infants were randomly assigned t o receive treatment with either a glucose-based oral-rehydration solut ion (ORS) (Pedialyte, Ross Laboratories, Columbus, OH) or a lice syrup solids-based ORS (Infalyte, Mead Johnson Nutritional Group, Evansvill e, IN). After rehydration was achieved, patients entered a maintenance phase during which, in addition to a maintenance ORS, breast milk or a soy-based formula was offered; infants older than 1 year were also g iven a lactose-free diet. Outcome measures. Rehydration was judged cli nically Infants remained on a metabolic bed during the study in to sep arate and quantitate urine and stool output. Therefore, in addition to clinical outcome, we compared intake, output and apparent absorption and retention of fluid, sodium, and potassium between groups. Results. All patients were successfully rehydrated using an ORS without the us e of intravenous fluids. No differences were detected between treatmen t groups in time to rehydration, percentage of weight gain after rehyd ration, consumption of ORS to achieve rehydration, or stool output. Ho wever, the apparent sodium absorption (net intake less fecal output) w as greater in the Infalyte group than the Pedialyte group during the f irst 24 hours. Conclusion. The two maintenance oral electrolyte soluti ons (Pedialyte and Infalyte) most commonly used in the United States a re effective as rehydration solutions for infants with mild to moderat e dehydration. We speculate that a strategy for oral rehydration thera py in the United States, based on the use of a single solution during the rehydration and maintenance phase, might gain additional acceptanc e by practicing pediatricians and family physicians.