Oral hydration rotavirus diarrhoea: a double blind comparison of sucrose with glucose electrolyte solution

Abstract

Of 57 male children, aged 5 months to 2 1/2 years with rotavirus diarrhoea, 28 were given oral therapy with sucrose electrolyte solution and 29 were given glucose electrolyte solution in a randomised double-blind trial. All were rehydrated and remained so on oral therapy alone. These patients were compared with 44 children, also with rotavirus, who were treated only with intravenous hydration. The oral therapy and intravenous therapy groups did not differ clinically in the rate of rehydration or the rate of purging. Vomiting did not prevent the giving of oral therapy during hospital admission. Bangladeshi children with rotavirus diarrhoea have a defect of carbohydrate digestion but this defect does not prevent the use of a sugar electrolyte solution for oral hydration.

PIP: The most important part of treatment of watery diarrhea is hydration. An oral glucose electrolyte solution is often used in place of intravenous therapy in diarrheal diseases caused by Vibrio cholerae, enterotoxigenic E. coli, and undiagnosed watery diarrheal diseases. In cholera and enterotoxigenic E. coli diarrhea, sucrose can be used in place of glucose, as sucrose can be hydrolized to fructose and glucose by intestinal dissacharidases, and it is also more readily available and cheaper than glucose. In a randomized double-blind trial of 57 male children (aged 5 months to 2 1/2 years) with rotavirus diarrhea, 28 were rehydrated with sucrose electrolyte solution and 29 were given glucose solution. The children were compared with 44 children, also with rotavirus diarrhea but treated only with intravenous hydration. There were no significant differences in the rate of rehydration or rate of purging between the 2 groups. Vomiting was not a factor in administering oral therapy during hospital admission. Patients with rotavirus infection may have defects of absorption and digestion of carbohydrates but such abnormalities should not prevent the use of sugar-electrolyte oral solution for hydration. Rotavirus infection is one of the most common causes of infantile diarrhea which necessitates hospital treatment. Either glucose or sucrose can be used in the solution, and this fact is especially important in developing countries where medical supplies are limited.