COMPARISON OF EFFICACY OF RACECADOTRIL VERSUS PROBIOTICS IN THE TREATMENT OF CHILDREN WITH ACUTE WATERY DIARRHOEA

Background: Acute watery diarrhea remains one of the leading causes of mortality and morbidity in children under five years of age, particularly in low- and middle-income countries. Rapid fluid loss can result in severe dehydration, necessitating effective management to reduce complications. Although oral rehydration therapy is the cornerstone of treatment, adjunct therapies such as antisecretory agents are being explored to improve outcomes. Racecadotril has emerged as a promising option; however, its local efficacy remains under-evaluated. Objective: To assess the effectiveness of racecadotril compared to probiotics in the treatment of acute watery diarrhea in children under five years of age. Methods: A randomized controlled trial was conducted at the Department of Pediatrics, Khyber Teaching Hospital, from January 3 to July 2, 2024. A total of 178 children aged 3 to 59 months with acute watery diarrhea were randomly assigned into two groups: Group A received racecadotril 1.5 mg/kg orally three times daily for five days, while Group B received 5 drops of Lactobacillus-based probiotic (100 million CFUs) once daily for the same duration. Efficacy was defined as normalization of stool frequency and consistency by day five. Data were analyzed using SPSS version 26 with a chi-square test; p ≤ 0.05 was considered statistically significant. Results: Mean age of participants in the racecadotril group was 28.89 ± 3.15 months, and in the probiotic group 29.99 ± 2.30 months. Male children comprised 67.4% in the racecadotril group and 53.9% in the probiotic group. Clinical efficacy was observed in 89.9% (n = 80) of patients receiving racecadotril, compared to 73.0% (n = 65) in the probiotic group. The difference was statistically significant (p = 0.004). Conclusion: Racecadotril demonstrated superior clinical efficacy over probiotics in the treatment of acute watery diarrhea in children under five years, indicating its potential role as an effective adjunct therapy.