Antibiotics Not Effective In Treatment Of Diarrhoea
AT THE beginning of the new millennium, even as several medical advancements for tackling many serious ailments come to our country, diarrhoea or acute gastroenteritis and acute respiratory infection still remain the two main killers in children below the age of five years, especially disadvantaged children.
In the case of diarrhoea the awareness of the importance of rehydration is the key to reducing mortality due to this disease. However, according to doctors, most parents insist on prescribing antibiotic to treat their children.
"Parents insist on antibiotics believing that antibiotics help in reducing the duration of diarrhoea. It is the bother of changing nappies ever so often that brings harassed parents to the doctors seeking a prescription for antibiotics. However, the parents fail to realise that antibiotics are absolutely useless in case of diarrhoea," explained Dr. Anupam Sibal, consultant paediatrician in Apollo Hospital.
Majority of the episodes of acute gastro-enteritis are caused by viruses, the commonest being rota virus. Antibiotics do not work against viruses and so they are useless.
Antibiotics can only help is the diarrhoea is due to bacterial infection. Not only to antibiotics not help, they can also lead to alterations in the microbial balance of the intestines which could have adverse effect, said Dr. Sibal.
Antibiotics are mere placebos and the normal duration of diarrhoea, five to seven days, cannot be reduced by the intake of antibiotics, said Dr. Sibal. He added that oral rehydration was most important in reduction of mortality.
Oral rehydration cannot shorten the duration of diarrhoea. This could be achieved by a probiotic and not an antibiotic.
"A probiotic is a live microbial feed supplement which beneficially affects the host by improving the intestinal ecosystem or intestinal microbial balance. An example of a commonly available probiotic is curds which had lactobacilli in it,"" said Dr. Sibal.
"During an episode of gastroenteritis there is a decrease of protective microflora in the intestine which is followed by an overgrowth of urease-producing pathogenic bacteria.
"Probiotics can help in the normalisation of the gastrointestinal microflora and shorten the duration," said Dr. Sibal. He stated that there were more effective probiotics available in the market which would cost about Rs. 2-3 per day and which could help in decreasing the duration of the diarrhoea. However, Dr. Sibal cautioned that there were no conclusive studies to prove that probiotics could effectively reduce the duration.
Dr. Sibal further stated that during diarrhoea people had a tendency to stop feeding the child which was not advisable as nutrition is paramount.
Most children from disadvantaged backgrounds are already suffering from malnutrition and further malnutrition would compromise their immunity making them more prone to diarrhoea in the future, he added.
The most crucial management of diarrhoea is rehydration, as it is dehydration that kills.
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