Treatment of infectious diarrhea in children
1. Infectious diarrhea in children
Factors from the child: The child's immune system is not yet mature while the passive antibodies transmitted from the mother gradually decrease as the child grows older. Along with that, the child's immune system declines when the child is malnourished or after contracting infectious diseases such as measles, mumps, chickenpox, etc., increasing the risk of diarrhea. Children love to explore around, so the risk of exposure to pathogens increases. Environmental factors: Contaminated food and drinking water of children, contaminated food processing equipment or hands. Adults improperly disposing of infected waste. Common diarrhea-causing bacteria are:
Enteric bacteria Escheriachia Coli (E.Coli) Shigella bacillus Shigella Campylobacter jejuni Salmonella Cholera Vibrio cholerae Bacteria that cause diarrhea after entering the digestive tract will produce release intestinal toxins. These toxins make the absorption of water and electrolytes in the small intestine disordered, a lot of water will enter the colon, unable to be reabsorbed, causing diarrhea.
Cholera diarrhea: rapid onset of illness within 24 hours, severe and continuous diarrhea in children, often with vomiting, no fever, turbid stools like water Wash rice, no stomach cramps, no straining. Diarrhea caused by dysentery: children have high fever, diarrhea many times, bloody mucus in the stool, children straining, abdominal cramps intermittently. Diarrhea caused by staphylococci: children with nausea, vomiting, no fever, diarrhea many times with watery stools. Diarrhea caused by E.coli: Diarrhea caused by E.coli enterotoxins (ETEC): children do not have fever, have loose stools without blood and mucus, the disease usually goes away on its own. Diarrhea caused by E.coli intestinal diseases (EIEC, EPEC, EHEC): fever, tenesmus, abdominal cramps, loose stools that may be mixed with bloody mucus. Diarrhea caused by Salmonella: diarrhea, vomiting, high fever, abdominal pain.
2. Treatment of infectious diarrhea in children
|Đánh giá||Phân loại|
Khi có 2 trong các tiêu chuẩn:
-Khó đánh thức, li bì
-Uống nước rất kém hoặc không uống được.
-Sau khi véo da, nếp véo mất rất chậm
|Trẻ bị mất nước nặng|
Khi có 2 trong các tiêu chuẩn:
-Kích thích, vật vã
-Khát, uống nước háo hức
-Sau khi véo dan, nếp véo da mất chậm
|Trẻ có mất nước|
|Không đủ dấu hiệu chứng tỏ trẻ có mất nước hoặc mất nước nặng||Trẻ không mất nước|
The most effective oral rehydration and electrolyte solution is Oresol solution (ORS). Mix the solution pack with the specified amount of water, absolutely do not mix less or more water because the osmotic pressure is not guaranteed, and it can even be dangerous. If the child has no signs of dehydration, in children under 2 years old give 50-100ml, children over 2 years old drink 100-200ml after each diarrhea and between diarrhea. If the child is already showing signs of dehydration, the amount of ORS solution to be given to the child within the first 4 hours is calculated by the formula:
Estimated amount of ORS (ml) needed = weight of the child (kg) x 75.
Antibiotics to treat diarrhea caused by cholera
Give children effective antibiotics against cholera strains in epidemic areas epidemiology. The first dose of antibiotics should be given as soon as the patient stops vomiting, usually 4 to 6 hours after rehydration.
Commonly chosen antibiotics are:
Azithromycin dose of 6-20 mg/kg orally once a day, orally for 1 to 5 days. Alternative antibiotics are:
Erythromycin 40mg/kg body weight, oral for 3 days dysentery in endemic areas. Dosage is as follows:
Ciprofloxacin 15mg/kg/time, taken 2 times a day, lasting for 3 days.
Pivecillinam: 20mg/kg/time, orally twice a day, for 5 days Ceftriaxone: 50-100mg/kg/time, intravenously or intramuscularly once a day, treat for 2 days -5 days. Some antibiotics are no longer effective in the treatment of bacillary dysentery recommended by the Ministry of Health:
Metronidazol Streptomycin Amoxicillin Tetracycline Chloramphenicol Nitrofuran Aminoglycoside Cephalosporin Generation I and II Nalidixic Acid (recommended by WHO) Antibiotics for diarrhea Diarrhea caused by Campylobacter:
The recommended antibiotic is Azithromycin, dose 6-20mg/kg/time, taken once a day, treatment for 1 to 5 days.
When children have diarrhea, zinc supplements should be given to children at a dose of 10mg/day in children under 6 months of age and 20mg/day in children older than 6 months for 10-14 days. Zinc helps strengthen the immune system, reduce the severity of diarrhea, improve appetite and growth of children.
Supplement with vitamin A after each episode of diarrhea to prevent vitamin A deficiency causing corneal damage.
Limit the use of anti-diarrheal drugs for children such as Kaolin, Smectic, Loperamide, Bismuth, ... because of unclear effects, many side effects, some drugs also cause prolonged diarrhea.
3. Prevention of infectious diarrhea in children
Enhance food hygiene and safety, let children eat cooked and drink boiling water. Choose a source of clean, hygienic water to use. Wash your hands often with soap and water: wash your hands thoroughly after using the toilet, after using the toilet, before preparing food for children and before serving children.
Để đặt lịch khám tại viện, Quý khách vui lòng bấm số HOTLINE hoặc đặt lịch trực tiếp TẠI ĐÂY. Tải và đặt lịch khám tự động trên ứng dụng MyVinmec để quản lý, theo dõi lịch và đặt hẹn mọi lúc mọi nơi ngay trên ứng dụng.