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Chinese clinical practice guidelines for acute infectious diarrhea in children

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World Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Background

The guidelines addressed the evidence-based indications for the management of children with acute infectious diarrhea in Chinese pediatric population.

Data sources

The experts group of evidence development put forward clinical problems, collects evidence, forms preliminary recommendations, and then uses open-ended discussions to form recommendations. The literature review was done for developing this guideline in databases including PubMed, Cochrane, EMBASE, China Biomedical Database, and Chinese Journal Full-text Database up to June 2013. Search the topic “acute diarrhea” or “enteritis” and “adolescent” or “child” or “Pediatric patient” or “Baby” or “Infant”.

Results

For the treatment of mild, moderate dehydration, hypotonic oral rehydration solutions (ORS) are strongly recommended. Intravenous (IV) rehydration is recommended for severe dehydration, with a mixture of alkali-containing dextrose sodium solution. Nasogastric feeding tube rehydration is used for children with severe dehydration without IV infusion conditions with ORS solution. Regular feeding should resume as soon as possible after oral rehydration or IV rehydration. The lactose-free diet can shorten the diarrhea duration. Zinc supplements are recommended in children with acute infectious diarrhea. Saccharomyces boulardii and Lactobacillus Rhamnus are recommended to be used in acute watery diarrhea. Saccharomyces boulardii is recommended in children with antibiotic-associated diarrhea as well. Montmorillonite and Racecadotril (acetorphan) can improve the symptoms of diarrhea or shorten the course of acute watery diarrhea. Antibiotics are recommended with dysenteric-like diarrhea, suspected cholera with severe dehydration, immunodeficiency, and premature delivery children with chronic underlying disease; otherwise, antibiotics are not recommended.

Conclusion

The principles of the most controversial treatments with of acute infectious disease are reaching to a consensus in China.

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Funding

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Author information

Authors and Affiliations

  1. Department of Gastroenterology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310051, China

    Jie Chen & You-Hong Fang

  2. Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu, 610041, China

    Chao-Min Wan

  3. Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou, 510623, China

    Si-Tang Gong & Yong-Sui Dong

  4. Department of Pediatrics, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Feng Fang & Zhi-Hua Huang

  5. Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, 110004, China

    Mei Sun

  6. Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020, China

    Yuan Qian

  7. Department of Gastroenterology, Children’s Hospital of Fudan University, Shanghai 201102, China

    Ying Huang

  8. Department of Infectious Diseases, Children’s Hospital of Fudan University, Shanghai, 201102, China

    Qi-Rong Zhu

  9. Department of Pediatrics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, 710038, China

    Bao-Xi Wang

  10. Department of Pediatrics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 350025, China

    Chun-Di Xu

  11. Department of Pediatrics, Fuzhou East Hospital, Fuzhou, 350025, China

    Li-Yan Ye

  12. Department of Pediatrics, Peking Union Medical College Hospital, Beijing, 100730, China

    Mei Dong

  13. Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, 210008, China

    Yu Jin

  14. Department of Gastroenterology, Children’s Hospital of Soochow University, Suzhou, 215003, China

    Qin-Bing Wu

  15. Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China

    Chao-Min Zhu

Authors
  1. Jie Chen
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  2. Chao-Min Wan
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  3. Si-Tang Gong
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  4. Feng Fang
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  9. Chun-Di Xu
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  10. Li-Yan Ye
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  11. Mei Dong
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  12. Yu Jin
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  15. Chao-Min Zhu
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  16. You-Hong Fang
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  17. Qi-Rong Zhu
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  18. Yong-Sui Dong
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Contributions

CJ designed the manuscript, CJ and FYH drafted and revised the final manuscript. WCM carried out the evidence based methodology. All the other authors collected data and wrote one part of the manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work. All authors contributed equally to this paper.

Corresponding author

Correspondence to Jie Chen.

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Conflict of interest

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

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Cite this article

Chen, J., Wan, CM., Gong, ST. et al. Chinese clinical practice guidelines for acute infectious diarrhea in children. World J Pediatr 14, 429–436 (2018). https://doi.org/10.1007/s12519-018-0190-2

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  • DOI: https://doi.org/10.1007/s12519-018-0190-2

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