This randomized clinical trial compared the efficacy of an oral rehydration solution (ORS) formulated with commercial rice powder, 50 g/l, with that of a glucose-based WHO/UNICEF-recommended ORS in the management of 48 inpatients aged 3-24 months, with acute dehydrating watery diarrhoea. Stool outputs were generally high in these patients, and 11 patients (22%) required additional intravenous rehydration solutions. The stool output (ml/kg) in the first 24 hours was [geometric mean, (95% confidence intervals)] 213 (153-353) in the rice-ORS group versus 146 (108-232) in the glucose-ORS group, while the total stool output was 455 (298-933) versus 307 (209-625); (p value not significant). The mean (+/- SD) duration of diarrhoea in hospital was: 72 +/- 10 hours in the study group versus 77 +/- 12 hours in the control group (p value NS). Enteropathogens were found in 94% of the patients, rotavirus being prevalent in 85% of the cases. It is concluded that the rice-ORS used in this trial is no more efficacious than the standard glucose-ORS advocated by WHO/UNICEF in the treatment of infants with watery non-cholera dehydrating diarrhoea. In some cases, ORS formulated with the commercial cereal-based products might actually increase the stool losses in infants with high-output non-cholera diarrhoea.
PIP: A randomized clinical trial compared the efficacy of an oral rehydration solution (ORS) formulated with commercial rice powder at 50 g/l (case group of 13 boys and 11 girls) with that of glucose-based WHO/UNICEF-recommended ORS (control group of 13 boys and 11 girls) in the management of 48 patients aged 3-24 months with acute dehydrating watery diarrhea in the pediatric ward of the Universidad Catolica Clinical Hospital, Chile. Enteropathogens were found in 94% of the patients. Rotavirus was present in 85% of the patients, either as a single pathogen (58%) or in association with other agents (27%). Enteropathogenic Escherichia coli (EPEC) was recovered in 33% of the patients; in 8% of the cases it occurred as a single pathogen and in 25% of the cases it was associated with rotavirus. 7 patients (29%) in the control group and 4 (17%) in the study group required intravenous fluids at some point in the course of the study. Mean fecal losses were generally higher in the rice-ORS patients throughout the study. The stool output (ml/kg) in the first 24 hours was 213 (153-353) [geometric mean (95% confidence interval)] in the rice-ORS group vs. 146 (108-232) in the glucose-ORS group, while the total stool output was 455 (298-933) vs. 307 (209-625) (p value not significant). The mean [+or- standard deviation (SD)] duration of diarrhea in hospital was: 72 +or- 10 hours in the study group vs. 77 +or- 12 hours in the control group (p value not significant). The ORS formulated with a commercial rice powder used in this trial is not superior to the standard glucose-ORS advocated by WHO/UNICEF in the treatment of infants with watery non-cholera dehydrating diarrhea. In some cases, ORS formulated with the commercial cereal-based products might actually increase the stool losses in infants with high-output non-cholera diarrhea.