Pediatric Gastroenteritis Medication

  • Author: Randy P Prescilla, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Nov 29, 2011
 

Medication Summary

Although antibiotic treatment clearly shortens the clinical illness and duration of pathogen excretion in dysentery caused by Shigella species, routine antibiotic use provides no clear advantage to treat gastroenteritis caused by Campylobacter jejuni, Yersinia enterocolitica, E coli, and Salmonella species.

Antibiotic administration may be considered for very young patients with Salmonella- caused gastroenteritis, for patients who are immunocompromised, and for patients who are systemically ill.

Evidence suggests that antibiotic treatment of enterohemorrhagic E coli infection may increase the risk for developing hemolytic uremic syndrome.

Rifaximin has excellent antibacterial activity and was approved in 2004 for the treatment for traveler's diarrhea caused by noninvasive strains of E coli.

Next

Antibiotics

Class Summary

In cases of Shigella enteritis, antibiotic treatment provides more rapid resolution of symptoms and faster fecal shedding of the organism. Trimethoprim-sulfamethoxazole (TMP-SMZ) is the drug of choice. In uncomplicated enteritis caused by nontyphoidal Salmonella species, antibiotics have no beneficial effect and may prolong the carrier state. The role of antimicrobials to treat enteritis caused by Campylobacter species, Y enterocolitica, and E coli remains controversial. Metronidazole is the recommended medication for G lamblia.

View full drug information

Sulfamethoxazole and Trimethoprim (Bactrim, Cotrim, Septra)

 

An antibacterial combination that may be used to treat enteritis caused by susceptible strains of Shigella flexneri and Shigella sonnei when antibacterial therapy is indicated.

View full drug information

Metronidazole (Flagyl)

 

Appears to be absorbed into cells where intermediate-metabolized compounds are formed that bind DNA and inhibit protein synthesis.

View full drug information

Rifaximin (Xifaxan, RedActiv, Flonorm)

 

Nonabsorbed (< 0.4%), broad-spectrum antibiotic specific for enteric pathogens of the gastrointestinal tract (ie, Gram-positive, Gram-negative, aerobic and anaerobic). Rifampin structural analog. Binds to beta-subunit of bacterial DNA-dependent RNA polymerase, thereby inhibiting RNA synthesis. Indicated for E coli (enterotoxigenic and enteroaggregative strains) associated with travelers' diarrhea.

Previous
Next

Vaccines

Class Summary

These agents elicit active immunization to increase resistance to infection. Vaccines consist of microorganisms or cellular components, which act as antigens. Administration of the vaccine stimulates the production of antibodies with specific protective properties.

View full drug information

Rotavirus vaccine (RotaTeq, Rotarix)

 

Currently, 2 orally administered live-virus vaccine are available.

RotaTeq contains 5 live human-bovine reassortant rotaviruses and is administered as a 3-dose regimen against G1, G2, G3, and G4 serotypes, the 4 most common rotavirus group A serotypes. It also contains attachment protein P1A (genotype P[8]).

Rotarix contains an attenuated human strain and is effective against rotavirus G1, G3, G4, and G9 strains and is administered as a 2-dose series in infants aged 6-24 wk.

Previous
Proceed to Follow-up
 
 
Contributor Information and Disclosures
Author

Randy P Prescilla, MD  Instructor in Anesthesia, Harvard Medical School; Assistant in Perioperative Anesthesia, Children's Hospital Boston

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Joseph Domachowske, MD  Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University

Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

References

  1. Youssef WF, Ramírez RP, Plana JC, Marfa MP. Benign afebrile convulsions in the course of mild acute gastroenteritis: a study of 28 patients and a literature review. Pediatr Emerg Care. Nov 2011;27(11):1062-4. [Medline].

  2. Rotavirus surveillance--worldwide, 2001-2008. MMWR Morb Mortal Wkly Rep. Nov 21 2008;57(46):1255-7. [Medline]. [Full Text].

  3. AAP. Practice parameter: the management of acute gastroenteritis in young children. Pediatrics. Mar 1996;97(3):424-35. [Medline].

  4. Szajewska H, Hoekstra JH, Sandhu B. Management of acute gastroenteritis in Europe and the impact of the new recommendations: a multicenter study. The Working Group on acute diarrhea of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. May 2000;30(5):522-7. [Medline].

  5. King CK, Glass R, Bresee JS, et al. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. Nov 21 2003;52(RR-16):1-16. [Medline].

  6. Amieva MR. Important bacterial gastrointestinal pathogens in children: a pathogenesis perspective. Pediatr Clin North Am. Jun 2005;52(3):749-77, vi. [Medline].

  7. CDC. Foodborne and Diarrheal Diseases Branch. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/foodborne/. Accessed April 24, 2006.

  8. CDC. Viral Gastroenteritis. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/ncidod/dvrd/revb/gastro/faq.htm. Accessed April 24, 2006.

  9. DeWitt TG, Humphrey KF, McCarthy P. Clinical predictors of acute bacterial diarrhea in young children. Pediatrics. Oct 1985;76(4):551-6. [Medline].

  10. DuPont HL. What's new in enteric infectious diseases at home and abroad. Curr Opin Infect Dis. Oct 2005;18(5):407-12. [Medline].

  11. Ericsson CD, DuPont HL. Rifaximin in the treatment of infectious diarrhea. Chemotherapy. 2005;51 Suppl 1:73-80. [Medline].

  12. Gastanaduy AS, Begue RE. Acute gastroenteritis. Clin Pediatr. Jan 1999;38(1):1-12. Review. [Medline].

  13. Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics. May 1997;99(5):E6. [Medline]. [Full Text].

  14. Huicho L, Sanchez D, Contreras M, et al. Occult blood and fecal leukocytes as screening tests in childhood infectious diarrhea: an old problem revisited. Pediatr Infect Dis J. Jun 1993;12(6):474-7. [Medline].

  15. Jimenez SG, Heine RG, Ward PB, Robins-Browne RM. Campylobacter upsaliensis gastroenteritis in childhood. Pediatr Infect Dis J. Nov 1999;18(11):988-92. [Medline].

  16. Lasche J, Duggan C. Managing acute diarrhea: what every pediatrician needs to know. Contemp Pediatr. 1999;16(2):74-82.

  17. Liebelt EL. Clinical and laboratory evaluation and management of children with vomiting, diarrhea, and dehydration. Curr Opin Pediatr. Oct 1998;10(5):461-9. [Medline].

  18. Murphy MS. Guidelines for managing acute gastroenteritis based on a systematic review of published research. Arch Dis Child. Sep 1998;79(3):279-84. [Medline].

  19. Nataro JP. Treatment of bacterial enteritis. Pediatr Infect Dis J. May 1998;17(5):420-1. [Medline].

  20. Powell EC, Hampers LC. Physician variation in test ordering in the management of gastroenteritis in children. Arch Pediatr Adolesc Med. Oct 2003;157(10):978-83. [Medline].

  21. US Food and Drug Administration. Rotarix Product Information. FDA.gov. Available at http://www.fda.gov/cber/label/rotarixLB.pdf. Accessed 11/27/2008.

  22. US Food and Drug Administration. RotaTeq Product Information. FDA.gov. Available at http://www.fda.gov/cber/label/rotateqlb.pdf. Accessed 11/27/08.

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.