Enterosorbents in the treatment of acute infectious diarrheal diseases
Acute infectious diarrheal diseases (AIDD) in children remain both a recent and prominent public health issue. The patterns of AIDD has changed in the recent years. Viral diarrhea is predominant (up to 70%), the main clinical sign of which is gastroenteritis syndrome. A syndrome of the same nature occurs in a number of bacterial infections, mainly caused by Escherichia, as well as by opportunistic flora. According to the modern approach to the treatment of diarrhea, the attitude towards antibacterial therapy, which is recommended only for enteroinvasive infections, has changed. Antiviral agents are being introduced to treat viral diarrhea. At the same time, enterosorption is one of the most effective types of etiopathogenetic therapy. New generations of modern enterosorbents appear in the medical practice such as Polisorb MP.
Goal of the research: To carry out a comparative evaluation of the efficacy of the new generation sorbent Polisorb and Smecta, which was the chosen alternative medication for AIDD treatment.
Two groups of patients with AIDD were taken. The 1st group consisted of 26 patients, in whose complex treatment Polisorb was used; The 2nd group consisted of 20 patients receiving Smecta. The two groups of patients with AIDD were randomly selected. The 1st group consisted of 26 patients, in whose comprehensive treatment Polisorb was used; 2nd group consisted of 20 patients receiving Smecta. The age of the patients in both groups varied from 1 to 3 years, both groups were comparable in terms of the severity of a disease: the moderate-severe form was mainly observed. Efficacy was evaluated according to the duration of the fever and the duration of the diarrhea syndrome. The average duration of fever in the 1st group was 1.83 days and in the 2nd group - 2.05 days. The duration of diarrheal syndrome in the 1st group was 1.59 days and in the 2nd group - 2.9 days. The duration of diarrhea syndrome in the 1st group was 1.59 days and in the 2nd group - 2.9 days. With OIDD of viral etiology in the 1st group and the 2nd group, the period of fever was 2.0 ± 0.29 and 2.1 ± 0.31, (p = 0.53), with bacterial diarrhea 2.21 ± 0.26 and 3.1 ± 0.59 days, respectively (p = 0.11). The difference in both etiological groups is not statistically significant. The duration of diarrhea in viral AIDD was 1.5 ± 0.22 and 2.2 ± 0.25 days. (р = 0.051), bacterial – 1.68 ± 0.34 and 3.6 ± 0.64 days (р = 0.0077) – a significant statistical difference.
Conclusion. No differences in the duration of fever were revealed after using Polisorb and Smecta in the complex therapy of AIDD. At the same time, Polisorb was more effective in alleviating diarrhea syndrome in both viral and bacterial AIDD. In addition, there was a better tolerance of Polisorb as there was no nausea and vomiting, which were observed with the use of Smecta. Conclusively, there was a better tolerance of Polisorb, without nausea and vomiting, which were observed with the use of Smecta.
(Proceedings of the 5th Annual All-Russian Congress on Infectious Diseases, Moscow, March 24-26, 2014 http://www.congress-infection.ru/Tezisi IB2014.pdf p.106)