maltodextrin and Acute-Disease

Male children (N = 101) 6-35 months of age presenting with acute watery diarrhea for less than 48 h at home before hospitalization were admitted into a randomized, double-blind clinical trial. Fifty-one children were treated with standard oral rehydration solution (ORS) (World Health Organization [WHO] formulation containing citrate) and 50 were treated with an improved ORS formulation (containing, in addition to the standard formula, 20 g maltodextrin instead of glucose, and 4 g glycine and 4 g glycyl-glycine). None were given antibiotics. No i.v. infusions were given. Rotavirus was detected by enzyme-linked immunosorbent assay in stools of 43 children. Clinical characteristics of children in the two treatment groups were comparable. Improved ORS did not produce significant reduction in the volume of diarrhea stools. Children given improved ORS had greater weight gain than that observed in children treated with standard ORS, but the differences were not statistically significant except at the end of the first 24 h. Among children with rotavirus diarrhea, no significant differences were observed between the 23 children who received improved ORS and the 20 who received standard ORS.

Topics: Acute Disease; Breast Feeding; Child, Preschool; Citrates; Defecation; Diarrhea; Diarrhea, Infantile; Double-Blind Method; Electrolytes; Fluid Therapy; Glucose; Glycine; Glycylglycine; Humans; Infant; Male; Osmolar Concentration; Polysaccharides; Rehydration Solutions; Rotavirus Infections; Weight Gain

We evaluated the efficacy and safety of an oral rehydration solution containing glycyl-glycine, glycine, and maltodextrin (GGG-ORS), in comparison to the glucose based ORS (standard ORS). The osmolality of the GGG-ORS (305 mOsm/l) and standard ORS (311 mOsm/l) was similar. Ninety-two children presenting with acute gastroenteritis and moderate dehydration, aged 3 months to 3 years, were randomly assigned to receive standard ORS or GGG-ORS. All the patients were successfully rehydrated orally. The two groups were comparable for baseline characteristics including the microbial etiology. Rotavirus (49%, 36%), ETEC (11%, 18%) or a combination of rotavirus and ETEC (15%, 9%) were the main stool pathogens isolated. There was no significant difference in the mean stool output or duration of diarrhoea between the two groups. Patients in the GGG-ORS group had higher urine output (p less than 0.01) and weight gain (p less than 0.05) in the initial 6 hours when feeding was withheld, but no such differences were observed beyond this period. Hypernatremia did not develop in any patient during the study. We conclude that glycine and glycyl-glycine supplemented oral rehydration solution does not have any therapeutic advantage in the treatment of acute gastroenteritis with moderate dehydration caused predominantly by rotavirus.

Topics: Acute Disease; Child, Preschool; Dehydration; Double-Blind Method; Fluid Therapy; Gastroenteritis; Glycine; Humans; Infant; Male; Polysaccharides; Randomized Controlled Trials as Topic; Rehydration Solutions