الفهرس 
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Abstract
Background:
Acute diarrhea cause high morbidity and mortality worldwide. Although oral rehydration therapy has reduced mortality associated with acute diarrhea, the diarrheal attack remains unchanged and stool volume often increases during rehydration process. Racecadotril is an enkephalinase inhibitor that decreases intestinal hypersecretion but not motility; it has proved effective and safe in children and adults with acute diarrhea when taken orally. The aim of the current study was to assess the effects of racecadotril as an adjuvant therapy to either oral rehydration solution or to nitazoxanide and metronidazole in children with acute diarrhea.
Method:
A randomized control study on two major groups ,group I 60 hospitalized patients , control group had only ORS ( 30 patients each) and treatment group received ORS plus oral racecadotril (1.5 mg / kg 3 times/ day), group II 90 outpatients, allotted into three groups 30 patients each (15 as control and 15 as treatment group each) , group II A control used nitazoxanide (100 mg/ 5 ml oral suspension 3 times / day), treatment group used nitazoxanide and racecadotril for three days, group II B, control had metronidazole (40 mg/ ml syrup 3 times / day) ,treatment had racecadotril and metronidazole , group II C, Control used ORS only, treatment used racecadotril and ORS. Racecadotril dose in outpatients was (1.5 mg / kg 3 times /day). outcome measures was ORS intake, duration of diarrhea and number and consistency of stools in hospitalized patients and number of bowel movements, stool consistency, duration of diarrhea and number of children followed up after treatment in outpatients.
Results:
In hospitalized patients, racecadotril with ORS reduced 48 hours total ORS intake significantly (905.2 ± 13.77) as compared to ORS intake in control group (961.5 ± 13.82) (P<0.001), mean duration of diarrhea (in days) reduced significantly (4.56 ± 0.38 vs.5.93 ± 0.30), mean number of bowel movements reduced significantly in treatment group (4.2 ± 0.63 vs 5.1 ± 0.69).
In Outpatients, racecadotril improved duration of diarrhea with nitazoxanide (2.9 ± 0.3), metronidazole (3.9 ± 0.3) and ORS (4.9 ± 0.2) (P<0.001) number of Patients with solid stools increased from initial visit to the 7 day visit in outpatients.
Conclusion racecadotril is an effective as an adjuvant therapy for treatment acute diarrhea in children
Keywords: Children, acute diarrhea, Racecadotril, adjuvant therapy.