TY - JOUR
T1 - Management of acute infectious diarrhea for children living in resource-limited settings
AU - O'Ryan G, Miguel
AU - Ashkenazi-Hoffnung, Liat
AU - O'Ryan-Soriano, Miguel A.
AU - Ashkenazi, Shai
PY - 2014/5
Y1 - 2014/5
N2 - Acute infectious gastroenteritis continues to be a leading cause of morbidity and mortality in children below 5 years of age, with the majority of deaths concentrated in 35 'low income' countries. In these countries the under five years of age mortality rates reach 100 per 1000 live births, of which a significant proportion are associated with acute diarrhea. Rotavirus, cryptosporidium, Shigella spp and enterotoxigenic Escherichia coli are the main pathogens causing disease in these settings, although other bacteria and parasites can cause moderate to severe disease in different regions and situations. Treatment of children in these setting should be focused on appropriate rehydration, early hospitalization of severely malnourished children, zinc supplementation, and in specific situations, antimicrobials should be considered. The rationale for antimicrobial use should be based on the potential benefits based on published literature and the opportunity for use. This review provides a pathogen-specific update on the potential benefits of antimicrobials and suggests an empirical management approach for children suffering an acute watery or bloody diarrhea in a resource-limited region.
AB - Acute infectious gastroenteritis continues to be a leading cause of morbidity and mortality in children below 5 years of age, with the majority of deaths concentrated in 35 'low income' countries. In these countries the under five years of age mortality rates reach 100 per 1000 live births, of which a significant proportion are associated with acute diarrhea. Rotavirus, cryptosporidium, Shigella spp and enterotoxigenic Escherichia coli are the main pathogens causing disease in these settings, although other bacteria and parasites can cause moderate to severe disease in different regions and situations. Treatment of children in these setting should be focused on appropriate rehydration, early hospitalization of severely malnourished children, zinc supplementation, and in specific situations, antimicrobials should be considered. The rationale for antimicrobial use should be based on the potential benefits based on published literature and the opportunity for use. This review provides a pathogen-specific update on the potential benefits of antimicrobials and suggests an empirical management approach for children suffering an acute watery or bloody diarrhea in a resource-limited region.
KW - Africa
KW - acute diarrhea
KW - antimicrobials
KW - developing world
KW - gastroenteritis
KW - management
KW - resource-deprived
KW - resource-limited
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=84898951824&partnerID=8YFLogxK
U2 - 10.1586/14787210.2014.901168
DO - 10.1586/14787210.2014.901168
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C2 - 24661314
AN - SCOPUS:84898951824
SN - 1478-7210
VL - 12
SP - 621
EP - 632
JO - Expert Review of Anti-Infective Therapy
JF - Expert Review of Anti-Infective Therapy
IS - 5
ER -