Oral rehydration solution with zinc/prebiotics limits diarrhea

Investigators in Italy examined the efficacy of a new hypotonic oral rehydration solution (ORS) containing zinc plus the prebiotics fructooligosaccharides (FOS) and xylooligosaccharides in treating children with acute diarrhea.

The 159 children in the study, brought to their pediatricians' offices with diarrhea lasting less than 24 hours with mild to moderate dehydration, were from 3 to 36 months old. Investigators assigned the children to either the standard hypotonic ORS group (group 1) or the super hypotonic ORS containing zinc and prebiotics group (group 2).

Diarrhea had resolved at 72 hours in half of group 1 compared with nearly three-quarters (73%) of group 2. Similarly, the number of daily outputs was significantly reduced in group 2 compared with group 1 at 24 hours, 48 hours, and 72 hours. Compared with group 2, group 1 had a significantly lower total ORS intake in the first 24 hours of rehydration. In addition, parents of children in group 1 missed significantly more working days than group 2 parents, and the rate of parents who missed at least 1 working day also was significantly higher in group 1. The rate of patients requiring hospitalization because of worsening symptoms was similar in the 2 groups, however, but after the first 72 hours more patients in group 1 than in group 2 required additional treatments. Neither group experienced any adverse events related to ORS use (Passariello A, et al. J Pediatr. 2011;158[2]:288.e1-292.e1).

Parents of children treated with this new solution reported missing an average of 0.39 days of work versus the 1.45 days reported by parents of the control group. Given the frequency of diarrheal illness in children and the reported differences between the 2 groups, use of this solution across large populations could have a profound effect on children, their families, and on health care costs. Minor modifications to ORS may allow major improvements in our treatment of this common ailment. -Michael Burke, MD