Acute Gastroenteritis: Evidence-Based Management of Pediatric Patients

Points & Pearls Excerpt

• Both vomiting AND diarrhea must be present for the diagnosis of acute gastroenteritis (AGE).
• Consider other etiologies in patients in whom vomiting has continued more than 24 to 48 hours without diarrhea or in patients with focal abdomi­nal tenderness.
• Most cases of AGE are due to viral pathogens and require minimal medical intervention; however, the course of bacterial causes of AGE tend to be more severe.

Most Important References

• Guarino A, Ashkenazi S, Gendrel D, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/ European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014;59(1):132-152. (Guideline) DOI: http://dx.doi.org/10.1097/MPG.0000000000000375
• Colletti JE, Brown KM, Sharieff GQ, et al. The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010;38(5):686-698. (Re­view) DOI: http://dx.doi.org/10.1016/j.jemermed.2008.06.015
• Bellemare S, Hartling L, Wiebe N, et al. Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of ran­domised controlled trials. BMC Med. 2004;2:11. (Meta-analy­sis; 14 studies) DOI: http://dx.doi.org/10.1186/1741-7015-2-11
• Freedman SB, Willan AR, Boutis K, et al. Effect of dilute apple juice and preferred fluids vs electrolyte mainte­nance solution on treatment failure among children with mild gastroenteritis: a randomized clinical trial. JAMA. 2016;315(18):1966-1974. (Prospective noninferiority study; 647 subjects) DOI: http://dx.doi.org/10.1001/jama.2016.5352
• Allen SJ, Martinez EG, Gregorio GV, et al. Probiotics for treat­ing acute infectious diarrhoea. Cochrane Database Syst Rev. 2010(11):CD003048. (Meta-analysis; 56 studies) DOI: http://dx.doi.org/10.1002/14651858.CD003048.pub3