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Chinese clinical practice guidelines for acute infectious diarrhea in children

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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”.


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.


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

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Authors and Affiliations



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.

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Correspondence to Jie Chen.

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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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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).

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