Rational Diarrhoea Management in Children. Essential Drugs Monitor No. 011 (1991)
(1991; 2 pages)


Oral rehydration salts (ORS) were introduced in the late 1960s. Shortly thereafter health professionals in the developed and developing world came to regard oral rehydration therapy (ORT) as the most effective treatment for patients suffering dehydration from diarrhoea. It is now known that effective management of diarrhoea also involves preventing dehydration at home, feeding children normally, and seeking help from trained health workers. Additionally, because most diarrhoea is self-limiting, the revised WHO diarrhoea treatment chart urges patients not to use antidiarrhoeals or antiemetics. To promote the acceptance of ORT and prevent irrational drug use, most countries in the developing world have implemented diarrhoeal disease control (CDD) programmes. Studies showed that, on average, hospital admission rates for diarrhoea dropped 61% after the introduction of ORT via CDDs. Despite this progress, drugs are still used irrationally to treat diarrhoea. For example, surveys showed that from 1988 to 1989, Peruvians spent US $2 million on antidiarrhoeal preparations. There are several disadvantages to such irrational use, such as the considerable cost incurred by countries and the potentially adverse effects of such use. Additionally, there is no scientific evidence to support the use of these drugs. To provide greater technical information on the efficacy and safety of drugs used to treat diarrhoea, the WHO CCD Programme reviewed all available literature dating back to the 1930s and compiled a book entitled “The rational use of drugs in the management of acute diarrhoea in children”. The book includes information on nine commonly used antidiarrhoeal drugs and concludes that there is no rationale for the production and use of any of the nine drugs for the management of acute diarrhoea in children. (Abstract by Flannery Bowman, 2013)

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