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World Journal of Pediatrics

, Volume 14, Issue 5, pp 429–436 | Cite as

Chinese clinical practice guidelines for acute infectious diarrhea in children

  • Jie Chen
  • Chao-Min Wan
  • Si-Tang Gong
  • Feng Fang
  • Mei Sun
  • Yuan Qian
  • Ying Huang
  • Bao-Xi Wang
  • Chun-Di Xu
  • Li-Yan Ye
  • Mei Dong
  • Yu Jin
  • Zhi-Hua Huang
  • Qin-Bing Wu
  • Chao-Min Zhu
  • You-Hong Fang
  • Qi-Rong Zhu
  • Yong-Sui Dong
Review Article

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.

Keywords

Children Diarrhea Dehydration Infection Rehydration Treatment Probiotics 

Notes

Author 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.

Funding

None.

Compliance with ethical standards

Ethical approval

Not required for this guideline.

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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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2018

Authors and Affiliations

  • Jie Chen
    • 1
  • Chao-Min Wan
    • 2
  • Si-Tang Gong
    • 3
  • Feng Fang
    • 4
  • Mei Sun
    • 5
  • Yuan Qian
    • 6
  • Ying Huang
    • 7
  • Bao-Xi Wang
    • 9
  • Chun-Di Xu
    • 10
  • Li-Yan Ye
    • 11
  • Mei Dong
    • 12
  • Yu Jin
    • 13
  • Zhi-Hua Huang
    • 4
  • Qin-Bing Wu
    • 14
  • Chao-Min Zhu
    • 15
  • You-Hong Fang
    • 1
  • Qi-Rong Zhu
    • 8
  • Yong-Sui Dong
    • 3
  1. 1.Department of Gastroenterology, Children’s HospitalZhejiang University School of MedicineHangzhouChina
  2. 2.Department of Pediatrics, West China Second HospitalSichuan UniversityChengduChina
  3. 3.Department of GastroenterologyGuangzhou Women and Children’s Medical CenterGuangzhouChina
  4. 4.Department of Pediatrics, Tongji Hospital Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  5. 5.Department of GastroenterologyShengjing Hospital of China Medical UniversityShenyangChina
  6. 6.Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
  7. 7.Department of GastroenterologyChildren’s Hospital of Fudan UniversityShanghai 201102China
  8. 8.Department of Infectious DiseasesChildren’s Hospital of Fudan UniversityShanghaiChina
  9. 9.Department of Pediatrics, Tangdu HospitalThe Fourth Military Medical UniversityXi’anChina
  10. 10.Department of Pediatrics, Ruijin Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
  11. 11.Department of PediatricsFuzhou East HospitalFuzhouChina
  12. 12.Department of PediatricsPeking Union Medical College HospitalBeijingChina
  13. 13.Department of GastroenterologyChildren’s Hospital of Nanjing Medical UniversityNanjingChina
  14. 14.Department of GastroenterologyChildren’s Hospital of Soochow UniversitySuzhouChina
  15. 15.Department of Infectious DiseasesChildren’s Hospital of Chongqing Medical UniversityChongqingChina

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