Clinical practice guidelines for acute infectious diarrhea in children in China (2024).

Abstract

Background: Some new progress and evidence have been made in the diagnosis and treatment of pediatric acute infectious diarrhea since the publication of the "Chinese clinical practice guidelines for acute infectious diarrhea in children" (2018 edition guidelines). The updated "Chinese clinical practice guidelines for acute infectious diarrhea in children" incorporates new evidence-based recommendations for managing acute infectious diarrhea in the Chinese pediatric population.

Data sources: Building on the 2018 edition guidelines, expert panels reviewed clinical evidence, assessed preliminary recommendations, and conducted open-ended discussions to finalize the updated guidelines. These guidelines are founded on the latest literature and evidence-based practices. A literature review was performed in databases such as PubMed, Cochrane, EMBASE, China Biomedical Database, and the Chinese Journal Full-text Database up to June 2024. The search focused on the terms "acute diarrhea" or "enteritis", along with "adolescent", "child", "pediatric patient", "baby", or "infant".

Results: The updated guidelines address various aspects of acute infectious diarrhea, including diagnosis, etiological evaluation, dehydration assessment, fluid therapy, diet therapy, medical therapy, and prevention strategies. The main updates focused on etiological diagnosis and the use of probiotics, racecadotril, zinc, and antibiotics in treating acute infectious diarrhea.

Conclusions: The updated guidelines address disputed treatments for acute infectious diarrhea through evidence-based revisions. Standardized etiological evaluations guide management. Probiotics are moderately advised for viral watery diarrhea; racecadotril remains unsupported. Zinc supplementation is recommended for children >6 months in deficient regions. Antibiotics are restricted to cases with dysenteric-like symptoms, suspected cholera with severe dehydration, or comorbidities.