Management of acute diarrhea in infants

In 1999, children seen in the emergency room of a developed country for wat ery diarrhea and dehydration will most likely receive an intravenous infusi on of fluid, followed by instructions to give oral rehydration solution (OR S) and clear liquids for a day, followed by half-strength lactose-free form ula. In fact, the majority of these children could best be managed with sup ervised ORS followed by early (within 4-6 h) refeeding of their normal diet , based on large numbers of clinical trials and a mete-analysis. In the nex t decade, effective therapy in addition to glucose-containing oral rehydrat ion solutions should be available which should reduce diarrheal volume and duration of purging. These include amino acid-supplemented "Super ORSs," OR S with soluble fibers, liquid zinc, and probiotic milks containing bacteria which boost the immune response and reduce stool number. In addition, chil dren wealthy enough to be able to afford the new tetravalent vaccine will b e largely protected from dehydrating rotavirus diarrhea, the most common ca use of dehydration in infants.