TY - JOUR
T1 - Alanine-based oral rehydration solution
T2 - Assessment of efficacy in acute noncholera diarrhea among children
AU - Sazawal, S.
AU - Bhatnagar, S.
AU - Bhan, M. K.
AU - Saxena, S. K.
AU - Arora, N. K.
AU - Aggarwal, S. K.
AU - Kashyap, D. K.
PY - 1991/5
Y1 - 1991/5
N2 - This randomized, double-blind trial determined whether adding 90 mmol/L of alanine with a reduction in glucose to 90 mmol/L (alanine ORS) improves the efficacy of the standard oral rehydration solution (WHO-ORS). One hundred twenty-nine males aged 3, 48 months with weight for length 3=70% of NCHS, diarrheal duration =£96 h, and clinical signs of mild to moderate dehydration were randomly allocated to either treatment group. During 0-6 h of treatment, ORS was offered at 120 ml/kg for rehydration without food or water. Beyond 6 h, ORS was offered as a volume-to-volume replacement for stool losses and a mixed diet of uniform composition was offered in amounts standardized for body weight. The most frequently isolated pathogens in alanine ORS and WHO-ORS groups were rotavirus (42 and 48%, respectively) and enterotoxigenic Escherichia coli (15 and 12%, respectively). In the 0-6 h period when food was withheld, me-dian urine output in ml/kg (8;5, p < 0.05) and percentage decrease in total serum solids (9:7%, p = 0.06) was sig-nificantly greater in alanine ORS than in WHO-ORS; median ORS intake and stool output were marginally lower in the alanine group but the differences were statistically not significant. Between 0 h and recovery, although the median values for duration of diarrhea (56.5 and 65.0 h), ORS consumption (260 and 323 ml/kg), and stool output (188.4 and 216.3 g/kg) were lower in the alanine ORS group, these differences with the WHO-ORS group were not statistically significant. Our findings are consistent with improved efficacy of WHO-ORS following alanine fortification but the clinical benefits achieved in these mildly dehydrated cases fall short of what may be clinically meaningful and of relevance to public health.
AB - This randomized, double-blind trial determined whether adding 90 mmol/L of alanine with a reduction in glucose to 90 mmol/L (alanine ORS) improves the efficacy of the standard oral rehydration solution (WHO-ORS). One hundred twenty-nine males aged 3, 48 months with weight for length 3=70% of NCHS, diarrheal duration =£96 h, and clinical signs of mild to moderate dehydration were randomly allocated to either treatment group. During 0-6 h of treatment, ORS was offered at 120 ml/kg for rehydration without food or water. Beyond 6 h, ORS was offered as a volume-to-volume replacement for stool losses and a mixed diet of uniform composition was offered in amounts standardized for body weight. The most frequently isolated pathogens in alanine ORS and WHO-ORS groups were rotavirus (42 and 48%, respectively) and enterotoxigenic Escherichia coli (15 and 12%, respectively). In the 0-6 h period when food was withheld, me-dian urine output in ml/kg (8;5, p < 0.05) and percentage decrease in total serum solids (9:7%, p = 0.06) was sig-nificantly greater in alanine ORS than in WHO-ORS; median ORS intake and stool output were marginally lower in the alanine group but the differences were statistically not significant. Between 0 h and recovery, although the median values for duration of diarrhea (56.5 and 65.0 h), ORS consumption (260 and 323 ml/kg), and stool output (188.4 and 216.3 g/kg) were lower in the alanine ORS group, these differences with the WHO-ORS group were not statistically significant. Our findings are consistent with improved efficacy of WHO-ORS following alanine fortification but the clinical benefits achieved in these mildly dehydrated cases fall short of what may be clinically meaningful and of relevance to public health.
KW - Alanine
KW - Children
KW - Diarrhea
KW - Oral rehydration solution
UR - http://www.scopus.com/inward/record.url?scp=0025847271&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025847271&partnerID=8YFLogxK
U2 - 10.1097/00005176-199105000-00009
DO - 10.1097/00005176-199105000-00009
M3 - Article
C2 - 1865280
AN - SCOPUS:0025847271
SN - 0277-2116
VL - 12
SP - 461
EP - 468
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 4
ER -