Patient's question:
Please ask the pediatric specialist; I have a little grandson who is nearly ten months old. He has had diarrhea for nearly ten days. In the first few days, it was just loose stools, and he was given Mamai and Simida, but it did not improve. So, we took him to the pediatric hospital for IV fluids. After two days of IV fluids, not only did his condition not improve, but it worsened. He has been having ten or more watery bowel movements that are white with a slight greenish tint. Before the IV fluids, his stool test showed no bacteria, but after the IV fluids, it tested positive for bacteria. How should this be treated? We are truly at a loss. My little grandson is usually very healthy, fair-skinned, and plump, with good digestion. This is the first time he has had diarrhea. Despite the severity of his diarrhea, the child is in good spirits and has a good appetite. Currently, we are controlling hisDoctor's answer:
Hello: Treatment of Pediatric Diarrhea:(1) Dietary Therapy
Appropriate nutritional support during diarrhea is crucial for promoting recovery, reducing weight loss and growth stunting, shortening the recovery period after diarrhea, and preventing malnutrition. After diarrhea stops, continue providing nutrient-rich foods with an additional snack daily for 2 weeks to catch up on normal growth. Children with malnutrition or those in the recovery phase of chronic diarrhea may require a longer duration until malnutrition is resolved.
(2) Care
For infectious diarrhea, attention should be paid to disinfection and isolation. Monitor vomiting, bowel movements, and urination. Administer water or saline solutions for oral rehydration at scheduled times and control the rate of intravenous fluid infusion. Strengthen eye care to prevent aspiration from vomiting. Turn the child frequently to prevent secondary pneumonia.
(3) Controlling Infection
Viral gastroenteritis is primarily treated with dietary therapy and supportive care, and antibiotics are not required. Non-invasive bacterial acute gastroenteritis is often self-limiting, and supportive therapy alone may suffice. However, antibiotics are still recommended for newborns, infants, weakened children, and severe cases. Invasive bacterial gastroenteritis generally requires antibiotic treatment.
1) Escherichia coli: Gentamicin, pipemidic acid, ofloxacin, furazolidone, certain cephalosporins, cotrimoxazole, berberine, ampicillin, etc.
2) Campylobacter fetus: Erythromycin, gentamicin, chloramphenicol, furazolidone, ofloxacin.
3) Yersinia enterocolitica: Gentamicin, chloramphenicol, ofloxacin, cotrimoxazole.
4) Salmonella typhimurium: Ampicillin, gentamicin, ciprofloxacin, cefazolin, cefotetan.
5) Staphylococcus aureus: Discontinue the original treatment.