DATA-ANALYSIS ON INFANT DIARRHEA TREATMEN T IN FRANCE

Oral rehydratation therapy is widely used in the treatment of infanti diarrhea, nevertheless antidiarrheals are still widely used in France as well as In developing countries, where diarrhea is a major cause of infantile death. Because of the links between France and French-speak ing countries of Africa, practices concerning the promotion of these d rugs and their use are similar and any modification in France will be effective in these countries. This study is based on data research and analysis concerning the treatment of diarrhea in children and the use of antidiarrheals, as published in the medical pharmaceutical, and la y press in France. The sections of data sheet compendium, Vidal Dictio nary, the main official source of information for French practitioners , have also been analyzed in the light of scientific reference data an d WHO recommendations. Results: the information published in the major medical journals in 1993, 94, and 95 differ according to the quality of the quoted studies: some of them lacking rigor, seem to be essentia lly designed for the promotion of some specialties. In the pharmaceuti cal press, targeted far pharmacists, a number of specialties are recom maended, but oral rehydratation therapy is rarely mentioned, The same heterogeneity exists in the information targeted for parents in the la y press and tile books. Antidiarrheals licensed on the French market a re numerous: 36 are listed in the Vidal 95, under 50 different formula tions, 14 of which are for pediatric use, not including oral rehydrata tion salts wich are considered in this book as dietary supplements. Da ta sheets for antidiarrheals in the Vidal Dictionary show some discord ance ill indications, contra-indications, dosage, or adverse effects, as well as ambiguity on efficacy level, especially for active principl es not recommended by WHO. There is an important gap between recommend ations concerning the treatment of diarrhea in children and the inform ation published in this field, among which industry promotion of ''ant idiarrheals'' has an important place. There are no official guideline and prescribers should be aware of the necessity of modifying an irrat ional and obsolete therapeutic strategy.