Diarrhoea management Age 4-12 Yr Choice of antibiotic And other treatments

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Diarrhoea is alterad bvowel pattern , altered frequency,altered consistency & volume. Dysentery is fever+blood mucus in stool +tenesmus Management depends upon severity of diarrhoea + ?? Dehydration, Our aim should be to prevent diarrhoea by personal hygiene,hand wash, During diarrhoea maintain Rehydration by ORS for mild-to-moderate dehydration, in severe dehydration child has to be admitted for IVF. Antibiotics are generally not required in diarrhoea.c exceptions Antibiotics are needed in Dysentery eg.Shivella, Salmonella,E.coli, Usual Antibiotics are ,Septran ,cefexime, parenteral Taxim, Ceftriaxone, etc. For Cholera ....Dixycycline, For Amebiasis..&Giardiasis..Metrinidazole Probiotics& Prebiotics are used as Adjuvant Rx

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DIARRHEA TREATMENT HAS FOUR COMPONENTS : 1. TREATMENT OF DEHYDRATION : (a) No dehydration :- Home fluid. Eg. Coconut water. (b) Some dehydration :- WHO recomended low osmolarity ORS in addition to home fluid. Frequent sips + extra 15-20 ml after each stool (less in young child/infant). (c) Severe dehydration :- If stool pass > vomiting then IV fluid RL is preferred but if vomiting is predominant and in diabetic IV fluid NS is given. 2. MUCOSAL HEALING : Zinc is given for mucosal healing specially in children/infant. If age is less than 6 months then 10 mg OD but if more than 6 months or adult the dose is 20 mg OD for 14 days. 3. RESTORING OF GUT FLORA : If diarrhoea is prolonged , IBS and in antibiotic associated diarrhoea floral loss is significant which needs restoration so Pre-Probiotic is given. 4. TREATMENT OF INFECTION : (a) Clinical conditions and circumstances that may indicate antibiotic therapy. i. DYSENTERIC DIARRHEA : Organisms :- Shigella, Yersinia, Campylobacter Rx :- Azithromycin, ciprofloxacin (FQs not given in young child/infant). ii. FEVER, INCREASED INFLAMMATION MARKERS :- Organisms :- Shigella Rx :- Azithromycin, ceftriaxone iii. PROLONGED DIARRHOEA : Organisms :- Gram-negative enterobacteria, Clostridium difficile Rx :- Metronidazole, co-trimoxazole iv. SIBO/IBS : Organisms :- Gram-negative enterobacteria Rx :- Metronidazole, rifaximin, co-trimoxazole v. ANTIBIOTIC ASSOCIATED DIARRHOEA : Organisms :- Clostridium difficile, others Rx :- Metronidazole, vancomycin (only if�Clostridium difficile�is detected) vi. TRAVELLER'S DIARRHEA : Organisms :- ETEC, EPEC Rx:- Azithromycin, ciprofloxacin (FQs are avoided in young children/infants). 7. TOXIC STATE : Organisms :- Gram-negative enterobacteria, Clostridium difficile Rx:- Ceftriaxone ** Watery diarrhoea or diarrhea with fever only indicate viral origin which needs no antibiotic. However loperamide (Safe in pregnancy) or Racecadotril is given in secretory diarrhoea.

Thank you doctor

this a very vague type of question . paediatric patients arent miniature adults . plus chances of infective diarrhea arises after 2 years . zinc probiotics n ors mandatory for all . but if u suspect infective diarrhea give syp o2 1/4 th weight of the child like for 20 kg 5 ml twice daily

Probiotics, ors, zinc 20mg once daily for 2 weeks Sometimes toddlers diarrhea due to sugary drinks Antibiotics are required only if there is dysentery, salmonella ,cholera, giardiasis and amoebiasis .

Thank you doctor

Depends upon the cause of diarrhea Viral, bacterial. The general treatment is Prevention of dehydration Mucosal repair Probiotics Treatment of cause of diarrhea.

Dear Dr. Nayan Baman Sir, Advice for the case. Tab. Agnitundi Vati 1 BD Bel Murabba.

Thanks @Dr. Nayan Baman Sir.

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