The following therapies have been suggested in the management of paediatric gastroenteritis:
Antibiotics
The majority of cases of paediatric gastroenteritis are viral and antibiotics are not required. Even cases of bacterial or protozoal infection are generally self-limiting. [1]
Antibiotics should not be used for otherwise healthy children with Salmonella gastroenteritis as a carrier state may result. [2]
Advice should be sought in cases of children with Shiga toxin-producing Escherichia coli (STEC) infection regarding monitoring for haemolytic uraemic syndrome. [1]
Antibiotics should only be given in cases of:
Anti-diarrheal agents
These are not recommended [1].
Probiotics
These are not recommended by NICE. [1] Subsequent reviews have suggested a potential role, [16] with studies ongoing in this area.
Antiemetics
These are not explicitly recommended by NICE. [1]
Subsequent evidence showed that a single oral dose of ondansetron helps to stop vomiting and reduce the number needing IV fluid and admission. [17] Its use is recommended by American guidelines. [18]
Ondansetron is associated with increased frequency of diarrhoea, so is not recommended in children with moderate to severe diarrhoeal symptoms. There is also a risk of prolongation of the QT interval, especially in children with electrolyte abnormalities, so ECG monitoring is recommended. [2]