Antimicrobial drugs for persistent diarrhoea of unknown or non-specific cause in children under six in low and middle income countries: systematic review of randomized controlled trials

Abba, Katharine, Sinfield, Rebecca, Hart, C. Anthony and Garner, Paul ORCID: https://orcid.org/0000-0002-0607-6941 (2009) 'Antimicrobial drugs for persistent diarrhoea of unknown or non-specific cause in children under six in low and middle income countries: systematic review of randomized controlled trials'. BMC Infectious Diseases, Vol 9, e24.

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Abstract

Background

A high proportion of children with persistent diarrhoea in middle and low income countries die. The best treatment is not clear. We conducted a systematic review to evaluate the effectiveness of antimicrobial drug treatment for persistent diarrhoea of unknown or non-specific cause.

Methods

We included randomized comparisons of antimicrobial drugs for the treatment of persistent diarrhoea of unknown or non-specific cause in children under the age of six years in low and middle income countries. We searched the electronic databases MEDLINE, EMBASE, LILACS, WEB OF SCIENCE, and the Cochrane Central Register of Controlled Trials (CENTRAL) to May 2008 for relevant randomized or quasi randomized controlled trials. We summarised the characteristics of the eligible trials, assessed their quality using standard criteria, and extracted relevant outcomes data. Where appropriate, we combined the results of different trials.

Results

Three trials from South East Asia and one from Guatemala were included, all were small, and three had adequate allocation concealment. Two were in patients with diarrhoea of unknown cause, and two were in patients in whom known bacterial or parasitological causes of diarrhoea had been excluded. No difference was demonstrated for oral gentamicin compared with placebo (presence of diarrhoea at 6 or 7 days; 2 trials, n = 151); and for metronidazole compared with placebo (presence of diarrhoea at 3, 5 and 7 days; 1 trial, n = 99). In one small trial, sulphamethoxazole-trimethoprim appeared better than placebo in relation to diarrhoea at seven days and total stool volume (n = 55).

Conclusion

There is little evidence as to whether or not antimicrobials help treat persistent diarrhoea in young children in low and middle income countries.

Item Type:	Article
Additional Information:	The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2334/9/24
Subjects:	WB Practice of Medicine > Therapeutics > WB 300 General works WS Pediatrics > Diseases of Children and Adolescents > By System > WS 312 Diarrheal disorders WI Digestive System > WI 100 General works WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WS Pediatrics > By Age Groups > WS 430 Infancy WB Practice of Medicine > Medical Climatology > WB 710 Diseases of geographic areas WS Pediatrics > By Age Groups > WS 410 Premature infants. Diseases of premature infants WB Practice of Medicine > Diagnosis > General Diagnosis > WB 143 Signs and symptoms WB Practice of Medicine > Diagnosis > General Diagnosis > WB 200 Physical diagnosis (General) WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WI Digestive System > WI 20 Research (General) WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology WS Pediatrics > By Age Groups > WS 421 Diseases of newborn infants WS Pediatrics > By Age Groups > WS 440 Preschool child
Digital Object Identifer (DOI):	https://doi.org/10.1186/1471-2334-9-24
Depositing User:	Philomena Hinds
Date Deposited:	22 Mar 2010 16:43
Last Modified:	17 Aug 2022 08:55
URI:	https://archive.lstmed.ac.uk/id/eprint/210

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