COMPARISON OF RACECADOTRIL WITH ORAL REHYDRATION SOLUTION IN ACUTE WATERY DIARRHEA UNDER 5 YEARS OF AGE

BACKGROUND: A significant share (18%) of paediatric mortality is caused by diarrheal diseases. Children under the age of five are most susceptible to viral diarrhoea. In cases of acute watery diarrhoea, racecadotril, an anti-secretory medication, can limit fluid and electrolyte loss from the intestine without compromising intestinal motility. OBJECTIVE: To compare the number of loose stools within the first 48 hours of admission between the children treated with and without Racecadotril, as well as the mean recovery time in children in both groups, in order to determine the efficacy of Racecadotril in treating acute watery diarrhoea in children aged 6 months to 5 years. METHOD: It was a Randomized Controlled Trial that ran from October 2020 to March 2021 at the Paediatrics Department at LGH/PGMI/AMC Lahore. Patients were divided into two equal groups at random using a computer-generated random number table. Racecadotril (1.5 mg/kg body weight, orally three times per day for 5 days or until diarrhoea ceases, whichever happens first) was given to 100 patients in group A coupled with Low Osmolality ORS, while Low Osmolality ORS was given to 100 patients in group B. For testing of blood haemoglobin, blood urea and creatinine, blood sugar, serum electrolytes, and stool (pH, microscopic inspection, culture, and sensitivity), blood samples were sent to a hospital pathology lab. As per operational definition, recovery time was documented. RESULTS: In our study, the mean recovery time was 37.88 hours in group A (racecadotril plus low osmolality ORS) and 47.40 hours in group B (low osmolality ORS), demonstrating a substantial reduction in recovery time of 20.08 percent (p value = 0.0026). The mean 48-hour stool frequency was 11.34 episodes in the Racecadotril + low osmolality ORS group and 14.98 episodes in the low osmolality ORS group, demonstrating a statistically significant decrease in stool frequency of 24.29 percent with the Racecadotril group (p value = 0.025). Faster recovery (20.08 percent) and a reduction of 20.52 percent in ORS consumption, which is comparable with earlier trials on Racecadotril conducted in children with acute watery diarrhoea. CONCLUSION:  In managing children under the age of five who have acute watery diarrhoea, we came to the conclusion that there is a substantial difference in the mean recovery time when Racecadotril and Low Osmolality Oral Rehydration Solution (ORS) are used in combination