Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bismuth subsalicylate (BSS) and placebo were evaluated in a double-blind, placebo-controlled study as adjunct to rehydration therapy in 123 children, aged 4 to 28 months, hospitalized with acute diarrhea. The dosing regimen was 20 mg/kg five times daily for 5 days. Significant benefits were noted in the BSS group compared with placebo as manifested by decreases in stool frequency and stool weights and an improvement in stool consistency, significant improvement in clinical well-being, and shortening of the disease duration. Patients treated with BSS had a significant reduction in duration of hospital stay (6.9 days) compared with placebo-treated patients (8.5 days). Also, intravenous fluid requirements decreased significantly more rapidly and to a greater degree in the BSS-treated group. Bismuth subsalicylate was associated with clearance of pathogenic Escherichia coli from the stools in 100% of cases but was not different from placebo in rotavirus elimination. Bismuth subsalicylate was well tolerated with no reported adverse effects. Blood bismuth and serum salicylate levels were well below levels considered toxic. In this study, BSS provided effective adjunctive therapy for acute diarrhea, allowing children to get well sooner with less demand on the nursing and hospital staff.
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PMID:Bismuth subsalicylate in the treatment of acute diarrhea in children: a clinical study. 198 13

Various available forms of therapy can decrease morbidity and mortality associated with acute diarrhea. Oral fluids represent the cornerstone of therapy of all cases. A variety of agents acting nonspecifically can decrease diarrhea and improve other worrisome symptoms associated with enteric infection. Kaopectate makes the stool more formed but has little additional effects. Bismuth subsalicylate, an antisecretory agent, reduces the number of stools passed by about 50 percent and improves other associated symptomatology. The drugs that affect motility such as loperamide and diphenoxylate are the most active of the nonspecifically acting drugs. They must be avoided in patients with significant fever and dysentery. Trimethoprim/sulfamethoxazole is now considered the drug of choice for shigellosis due to the presence of ampicillin-resistant Shigella strains in most regions of the world. Trimethoprim/sulfamethoxazole is also an effective form of therapy for enterotoxigenic Escherichia coli infection and for traveler's diarrhea without definable cause. Erythromycin, although not proved to be effective against Campylobacter, probably shortens the disease. Furazolidone, although not dramatically effective, has a spectrum of activity that includes Shigella, enterotoxigenic E. coli, Campylobacter, and Giardia lamblia. It may not be effective in severely ill (hospitalized) patients with diarrhea. The various forms of available therapy can be administered empirically, depending on symptomatology. Mildly ill patients (one to three unformed stools in 24 hours with minimal additional symptoms) probably are best treated with fluids only. Mild to moderately ill persons (three to six unformed stools in 24 hours) can be treated with a drug that acts nonspecifically, such as bismuth subsalicylate or loperamide. Those with severe diseases (six or more unformed stools with moderate to severe associated symptoms), particularly when associated with fever and the passage of bloody mucoid stools, may be given an antimicrobial agent. The antimicrobial drug given will be determined by ancillary laboratory tests (dark-field examination or examination of a wet-mount preparation for motile Campylobacter or stool culture for Shigella, Campylobacter, or Salmonella) or may be administered on an empiric basis. Traveler's diarrhea can be eliminated in selected persons by the administration of a pharmacologic agent. Liquid bismuth subsalicylate is effective in large doses, which may be impractical. Studies with the tablet formulation suggest that it is partially effective in preventing the illness. Doxycycline and trimethoprim/sulfamethoxazole are more effective, particularly when admini
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PMID:Nonfluid therapy and selected chemoprophylaxis of acute diarrhea. 389 19

ORS has led to improved outcome of acute gastroenteritis in both industrialised and developing countries. In both settings there is an increasing demand for active therapy to reduce the duration of diarrhoea and its complications. Persistent diarrhoea is a major consequence of intestinal infections and is responsible for a high number of deaths in poor countries. Bismuth subsalicylate has been used for treatment of acute diarrhoea, with preliminary promising results. In this issue of Acta Paediatrica, a trial with BSS is essential. However the results were marginal and did not justify a mass scale use of BSS, also because of poor cost efficacy rate.
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PMID:Which place for bismuth subsalicylate in the treatment of enteric infections? 1144 90

Acute diarrhea is still responsible for about 40% of diarrhea-associated deaths, and oral rehydration therapy (ORT) does not actually reduce the duration of diarrhea. A species of lactobacilli specific for the human gut was first isolated in 1987, Lactobacillus casei strain GG, and several trials have used colonization of the gut by this organism as an adjunct to ORT. A placebo-controlled, triple-blind study in Pakistan showed a significant reduction in the number of children with persistent watery stools at 48 hours, as well as a reduction in stool output and vomiting. Dioctahedral smectite (DS) has been found to adsorb viruses, bacteria, and toxins resulting in the protection of gut mucosa. A randomized double-blind trial (placebo-controlled) studied outcome in 90 males, 3-24 months old, with acute diarrhea of or= 5 days duration. After rehydration, patients were given either 1.5 g of DS or placebo 4 times a day for 3 days. At 48 hours, 42% of the treatment group were free from diarrhea, as opposed to 13% of the placebo group, and at 3.5 days 20% of the placebo group still had diarrhea, as opposed to none in the treatment group. Mean duration of diarrhea in the treatment groups was 54.1 hours (placebo 72.9 hours, p 0.001). However, mean stool output was similar (97.9 g/kg vs. 110.9 g/kg). Bismuth subsalicylate (BSS) has been frequently used in adults with benefits in both prevention and treatment. 142 Chilean children 4-36 months old were randomized to receive either placebo or BSS (100 mg/kg/day) 5 times a day for 5 days. Stools were normal in the E. coli group by 72 hours as opposed 139 hours in the placebo group (p 0.01), while rotavirus-infected stools normalized in 57.5 hours, as opposed to 104.5 hours in the placebo group. Other effective approaches include micronutrient supplementation including zinc and folate.
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PMID:Paediatrics Forum. Acute diarrhoea. 1231 47