Oral Rehydration Therapy of Infantile Diarrhea: A Controlled Study of Well-Nourished Children Hospitalized in the United States and Panama

Mathuram Santosham, Robert S. Daum, Ludwig Dillman, Jose L. Rodriguez, Sarah Luque, Rebecca Russell, Miguel Kourany, Robert W. Ryder, Alfred V. Bartlett, Allan Rosenberg, Abram S. Benenson, R. Bradley Sack

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Although oral glucose-electrolyte solutions containing 90 mmol of sodium per liter have been widely used in the treatment of acute diarrhea among under-nourished children in the developing world, they have rarely been studied in well-nourished children. We therefore conducted a controlled, randomized study among well-nourished children three months to two years old who were hospitalized with acute diarrhea (52 in the United States, and 94 in Panama), to compare the efficacy of this solution with that of one containing 50 mmol of sodium per liter and with standard intravenous therapy. Oral rehydration with both solutions according to protocol was successful in 97 of 98 children (one required unscheduled intravenous therapy), and in 87 (89 per cent) no intravenous therapy was required. All of six children admitted with hypernatremia were successfully treated with oral therapy alone. We conclude that glucose-electrolyte oral solutions containing either 50 or 90 mmol of sodium per liter are effective and safe in the treatment of well-nourished children hospitalized with acute diarrhea, and that they may completely replace intravenous fluids in the majority of such children. (N Engl J Med. 1982; 306:1070–6.), ORAL glucose-electrolyte solutions have been shown during the past 10 years to be highly effective in the treatment of dehydration secondary to acute diarrhea in the developing world.1 2 3 This therapy is based on the simple physiologic observation that active glucose absorption in the small bowel promotes the absorption of sodium.4,5 Oral rehydration therapy was first developed specifically for the treatment of cholera (in which intestinal glucose absorption was known to be normal), because of the need for a simpler, more available, and inexpensive treatment that could replace intravenous fluids, which were often unavailable in cholera-endemic areas.6 7 8 9 10 11 Since these early studies,.

Original languageEnglish (US)
Pages (from-to)1070-1076
Number of pages7
JournalNew England Journal of Medicine
Issue number18
StatePublished - May 6 1982

ASJC Scopus subject areas

  • Medicine(all)

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